PubMed Health⌕ Search

Biomedical subjects

A González López

Publications and source records attributed to A González López.

At least 19 recordsLinked to original sources

[Burden of hospitalizations attributable to rotavirus infection in children in the Autonomous Region of Madrid, Spain, period 1999-2000].

OBJECTIVE: To assess rotavirus infection requiring hospitalization in children aged < or = 5 years between 1999 and 2000 in the Autonomous Region of Madrid (Spain). MATERIAL AND METHOD: A retrospective study was conducted, based on the hospital data surveillance system (Conjunto Mínimo Básico de Datos [CMBD]) and on the Spanish national microbiological information system (Sistema de Información Microbiológica [SIM]). CMBD data for all hospital admissions in children aged < or = 5 years with a first-listed diagnosis of intestinal infectious disease (ICD-9-CM codes: 001-009) or non-infective gastroenteritis (ICD-9-CM code: 558) and the reports to the SIM of the major pathogen groups responsible for acute gastroenteritis were analyzed. RESULTS: The annual incidence of hospitalizations for acute gastroenteritis was 69 cases per 10,000 children aged < or = 5 years. Fourteen percent of the 32,541 infections produced by pathogens responsible for acute gastroenteritis reported to the SIM were rotavirus. The estimated annual incidence of hospitalizations due to rotavirus infections was 12 cases per 10,000 children aged (3/4) 5 years. The mean length of stay was 4.0 days, the annual mean number of days of hospitalization was 1,382 days, and the annual cost was 565,907 J. During the rotavirus epidemic months (December and January), the percentage of excess hospitalizations was 67 %. CONCLUSIONS: Rotavirus causes a significant proportion of hospital admissions due to acute gastroenteritis in children aged < or = 5 years in the Autonomous Region of Madrid.

Child, Preschool↗

[Granuloma annulare of the eyelid: an unusual presentation].

CASE REPORT: Granuloma annulare is a benign dermatosis, relatively common during childhood, usually self-limited and of unknown etiology. Localized ocular involvement is rare. We report a case of granuloma annulare involving the eyelid of a child. A biopsy taken from a similar lesion presented later on the back of a thumb confirmed the diagnosis. Treatment with topical corticosteroids was introduced. DISCUSSION: The literature on periocular granuloma annulare is reviewed. This diagnosis should be considered for any acquired papular of the periorbital area, especially if there is a history of antecedent trauma. Unnecessary surgical excision can then be avoided.

Administration, Topical↗

Long-term metabolic consequences of switching from protease inhibitors to efavirenz in therapy for human immunodeficiency virus-infected patients with lipoatrophy.

The roles of nucleoside analogues and protease inhibitors (PIs) in the development of metabolic complications and fat-distribution abnormalities associated with highly active antiretroviral therapy (HAART) are not well known. We performed an observational study in which efavirenz was substituted for a PI for 41 patients receiving HAART who had prolonged virus suppression, clinical signs of severe lipoatrophy, hyperlipidemia, and insulin resistance. Clinical follow-up was performed for 1 year. Virus suppression was maintained in most of the patients, and a significant increase in CD4(+) lymphocyte count was observed, but no change in lipid profile or insulin resistance was observed. Abdominal fat content did not change, and subcutaneous fat depletion was even more pronounced >1 year after the switch. We conclude that, for PI-treated patients who present with lipoatrophy, hyperlipidemia, and insulin resistance, substituting efavirenz for PIs can maintain virus suppression and immunologic response to HAART, but it does not improve the lipid profile or resolve insulin resistance or lipoatrophy.

Adult↗

[Value of the use of the geometric mean to calculate the relative renal function in 99mTc-DMSA renal scintigraphy].

Determining the relationship of DMSA uptake of the left versus right kidney is theoretically one of the easiest quantitative procedures in nuclear medicine. The quantification can be performed on the posterior view, with or without a lateral view for correction of kidney depth. The geometric mean can also be determined by using both the anterior and the posterior views. This study has aimed to evaluate if there are significant differences in the quantification of the renal function percentage using only the posterior view and the geometric mean. Furthermore, we evaluated to what extent the patient's age and diagnosis influenced these differences. We have proposed a work protocol in which we indicate which cases the geometric mean should be calculated in order to minimize the possible errors occurring when only the posterior view is used.A total of 328 renal scintigraphies with 99mTc-DMSA performed at our Department in the last six months were studied. The mean and standard deviation of the differences as well as the correlation coefficient between both methods were calculated. The difference between the right renal function in posterior view and the right renal function obtained using the geometric mean was calculated for all the patients. The Student's T test was applied to determine whether the differences between both methods were statistically different from zero. Statistical differences were found in patients older than 9 years and in patients with genitourinary malformations.

Adolescent↗

Risk factors for esophageal candidiasis.

The role of gastric acid inhibitors as predisposing factors for Candida esophagitis is unknown. A retrospective case-control study of esophageal candidiasis was conducted in human immunodeficiency virus (HIV)-negative patients diagnosed from January 1991 to December 1997. The diagnosis of esophageal candidiasis was always made on the basis of endoscopic and histological criteria. Fifty-one patients were diagnosed with esophageal candidiasis, 15 of whom had esophageal complaints and 48 of whom suffered from another previous chronic disease (17 had cancer). In addition, 20 patients had previously been treated with antibiotics, 13 with steroids and 14 with omeprazole. In the multivariate analysis, neoplasm (odds ratio, 5.50; 95% confidence interval, 1.94-15.56) and therapy with antibiotics (odds ratio, 11.97; 95% confidence interval, 3.82-37.45), steroids (odds ratio, 35.52; 95% confidence interval, 3.90-324.01) or omeprazole (odds ratio, 18.23; 95% confidence interval, 4.67-71.03) were all associated with esophageal candidiasis. These data suggest that Candida esophagitis tends to occur in patients with chronic diseases, most of whom have been previously treated with antibiotics, steroids or omeprazole. The findings support the hypothesis that treatment with omeprazole favors the development of esophageal candidiasis.

Aged↗

[Kikuchi's disease].

Explore the source record for details and available documents.

Diagnosis, Differential↗

[Seroprevalence of antibodies against measles, rubella, mumps and varicella among school children in Madrid].

OBJECTIVE: The aim of this study was to assess the seroprevalence of antibodies against MMR and varicella in a population of children between 6 and 7 years of age vaccinated against measles, mumps and rubella at 15 months of age. PATIENTS AND METHODS: This cross-sectional study was carried out in a group of healthy children (6-7 years of age) of the Autonomous Community of Madrid, Spain. Vaccination against MMR at 15 months of age was documented for all children included in the study. Blood samples were drawn from all participants and sera were stored at -20C until they were tested at the end of the study. Measles, mumps, rubella and varicella antibody levels were measured by means of the enzyme linked immunosorbent assay (ELISA) method (IgG Genzyme Virotech GmbH). Positive values were defined as optical density values of > or = 0.20 for measles, > or = 0.30 for mumps, > or = 0.40 for rubella and > or = 0.36 for varicella. Prevalence (and the corresponding 95% confidence limits) assessed by the presence of anti-measles, anti-mumps, anti-rubella and anti-VZV antibodies on the study population were calculated. The Chi-squared test was used to evaluate differences in prevalence between sexes. The Chi-squared test was used to evaluate differences in prevalence between the sexes. RESULTS: A total of 174 children were recruited between October and November 1997. The mean age (SD) and male/female ratio were 6.4 (0.5) years and 0.8 (45.6%/54.5%), respectively. Prevalence of antibodies against measles, rubella, mumps and varicella were 92% (88-96%), 95% (92-98%), 81% (76-86%) and 85% (90-90%), respectively. There were no significant differences between the sexes in relationship to the prevalence of measles, mumps, rubella or varicella antibodies. CONCLUSIONS: Approximately 20% of these 6 to 7 year old children vaccinated at 15 months of age were unprotected against the mumps. Eight percent and 5% were sero-negative for measles and rubella, respectively. Administration of the second dose of MMR vaccine at 4 to 6 years of age instead of at 11 years would contribute to avoid the accumulation of non-immune children. Eighty-five percent of the study population was sero-positive for VZV. These data suggest that, in Spain, VZV infections commonly affect children younger than 5 years of age.

Antibodies, Viral↗

[Quadrivalent vaccine against diphtheria, tetanus, B. pertussis and hepatitis B: experience in Spain].

OBJECTIVE: The objective of this study was to perform a pooled analysis of the immunogenicity and reactivity results obtained in 2 trials carried out in Spain with a combined DTP-HB vaccine. PATIENTS AND METHODS: Vaccine was administered according to one of two existing vaccination schedules: 2-4-6 and 3-5-7 months of age. Blood samples for antibody determination were obtained 3-6 weeks after the third dose. Anti-diphtheria, anti-tetanus and anti- B. pertussis antibodies were measured by ELISA and anti-HB by radioimmunoassay. Local and general signs and symptoms were recorded by the parents on diary cards for a 4-day follow-up period after each vaccination. RESULTS: A total of 231 infants received three doses of DTP-HB vaccine. All of these doses were accompanied by the corresponding diary card (693 data points for the evaluation of reactogenicity). Two-hundred and nineteen subjects ere included in the analysis of immunogenicity. After the full vaccination course, all subjects had sero-protective titers against diphtheria, tetanus and hepatitis B and were sero-positive of B. pertussis. Geometric mean titers of anti-HB antibodies was 1986 mIU/ml. Pain at the injection site (64%) and unusual crying (71.5%) were the most frequently reported local and general symptoms, respectively. Fever (rectal temperature > or = 38 degrees C) was reported after 46% of the doses, but was considered as severe (> 39.5 degrees C) only in 5 cases. CONCLUSIONS: These results show that this combined DTP-HB vaccine induced a strong immune response to all vaccine components. The safety profile of this DTP-HB is similar to that of classical DTP vaccines.

Antibodies, Viral↗

[Tuberculosis in a prison population: a study of 138 cases].

BACKGROUND: Tuberculosis continues to be a disease of great importance in Spain with few data known on prison populations. In the present study an analysis of the incidence and characteristics of tuberculosis in the prison population people is done. METHODS: The General Penitentiary Hospital attends a prison population from the penitentiary centers of Madrid and its surrounding areas. From 1 March 1991-31 August 1992 a retrospective study of the patients with tuberculosis diagnosed by culture isolation of Mycobacterium tuberculosis was performed. Demographic, clinical, analytical, microbiologic analysis as well as data concerning to associated infections, antituberculous treatment and its possible toxicity as well as the evolution of the patients were collected. RESULTS: During the period studied 138 patients--120 corresponding to the area of Madrid and 18 to patients referred from other penitentiary areas--were diagnosed. The rate of incidence of tuberculosis in the penitentiary population in the area of Madrid was of 1170.5 cases per 100,000 prisoners per year (confidence interval [CI] 95%; 961-1380). The mean age was 30 years (CI 95%; 29-31) and 97% were males. Eighty-four percent were positive for the human immunodeficiency virus (HIV) and 84% were intravenous drug addicts. The clinical form of presentation of the tuberculosis in the HIV positive patients was: pulmonary in 57% of the cases, disseminated in 29% and extrapulmonary in 14% and was pulmonary in all the cases of HIV negative patients. The mean CD4 lymphocytes count was 0.216 x 10(9)/l in HIV positive patients with pulmonary tuberculosis, and in disseminated tuberculosis was 0.062 x 10(9)/l (p < 0.001). The positivity of acid-alcohol resistant staining in the sputum samples and/or induced sputum was 67.4% in the patients with pulmonary tuberculosis and 77.4% in disseminated tuberculosis. Ten percent of the patients were found to abandon antituberculous treatment in the first trimester. CONCLUSIONS: The incidence of tuberculosis in the prison population in much higher than that for the general population in Spain, largely due to the high prevalence of HIV infection in this population.

Adult↗

[Bacteremia due to Mycobacterium tuberculosis in patients coinfected with the human immunodeficiency virus].

BACKGROUND: Since the appearance of AIDS, bacteremia by Mycobacterium tuberculosis is an event described with ever greater frequency. The isolation of M. tuberculosis in blood cultures in patients coinfected by the human immunodeficiency virus and M. tuberculosis may vary the initial clinical diagnosis and confirm the picture as disseminated tuberculosis. METHODS: The clinical records of patients admitted to the General Penitentiary Hospital of Madrid with significant bacteremia during the study period (March 1, 1991-September 1992) were retrospectively and prospectively reviewed. Special attention was given to the bacteremias by M. tuberculosis with the most significant clinical evolutive data being collected. The blood cultures were performed according to the routine technique using a non radiometric system with 10-day incubation and posterior processing of the sample for visualization and culture for mycobacteria. RESULTS: In an 18 moth period and out of a total of 284 positive blood cultures (154 significant isolations) 14 episodes of bacteremia by M. tuberculosis were studied in 12 prison patients coinfected by the human immunodeficiency virus with associated severe immunosuppression (mean of CD4 = 0.068 x 10(9)/l). All the patients were intravenous drug addicts. Likewise, 37 other significant bacteremias were reviewed. The positivity of the blood culture as the sole sample or associated to respiratory isolations, changed the initial diagnosis and classified the picture as disseminated tuberculosis on 6 occasions (43%). All the patients presented pictures of disseminated tuberculosis although only four had been previously diagnosed of AIDS. CONCLUSIONS: Bacteremia by M. tuberculosis is frequent in patients infected by the human immunodeficiency virus. M. tuberculosis (27.4%) was the most frequently isolated microorganism in blood cultures in this study. The processing of blood cultures for mycobacteria may be useful in patients positive for the human immunodeficiency virus with tuberculosis in order to confirm the diagnosis of disseminated tuberculosis. The isolation of M. tuberculosis in the blood may vary the initial diagnosis and could modify the prevalence of AIDS cases in Spain.

AIDS-Related Opportunistic Infections↗

[Antiphospholipid antibodies and cerebral infarction].

The antiphospholipid antibodies syndrome is clinically characterized by the presence of thrombosis, repetitive abortions and/or thrombopenia. During the past years, thanks to the development of techniques for its detection, its relationship with cerebrovascular accidents has become of special interest. Two patients with antiphospholipid antibodies and multiple cerebral infarcts are presented and the clinical and pathogenic aspects of this association are reviewed.

Antiphospholipid Syndrome↗