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Biomedical subjects

A J Roncoroni

Publications and source records attributed to A J Roncoroni.

At least 73 records · Page 4Linked to original sources
PubMed1989

[Cost and effectiveness of fecal culture in the etiologic diagnosis of acute diarrhea].

To study the cost-effectiveness of fecal culture in the detection of enteropathogenic or enteroinvasive bacteria, a review and analysis was done of fecal cultures from ambulatory or hospitalized patients treated for acute diarrhea at a Buenos Aires sanatorium during 1985. Of 1,295 fecal cultures performed, pathogens were isolated in 369 cases (28.5%), of which 79 corresponded to Shigella sp. (S. flexnerii, 49; S. sonnei, 29; S. dysenteriae, 2), 25 to Salmonella sp., and 270 to enteropathogenic Escherichia coli (EPEC) of the infant. There was no statistically significant difference between the ambulatory patients and the hospitalized patients in the proportion of positive fecal cultures. The cost of each positive fecal culture was US$ 60.36, while the cost of diagnosing invasion of the mucous membrane (isolation of Shigella sp. or detection of leukocytes in feces) was US$ 109.74. These costs are excessive and could be greatly reduced if the test were applied in only selected cases. Many of the strains of Shigella sp., Salmonella sp., and EPEC that were found were resistant to ampicillin, chloramphenicol, and cotrimoxazole. These cases of resistance suggest that fosfomycin may be one of the antibiotics of choice for the treatment of diarrhea caused by invasive organisms.

Acute Disease↗
PubMed1989

[Endocarditis due to Corynebacterium xerosis].

Corynebacterium sp. are found as normal flora in skin and mucosal sites. They have been isolated in empyemas, brain abscesses, blood cultures and ventricular shunts. About 9-10% of early-onset and 4-5% late-onset prosthetic valve endocarditis are due to different species of the so-called "diphteroids". A 30 year-old white female was admitted after 30 days with fever of undetermined origin. A mitral prosthesis had been fitted in 1977. On physical examination a protomesosystolic mitral murmur, petechiae, retinal hemorrhages and hepatosplenomegaly were detected. Laboratory tests showed 37% hematocrit, 14,800/mm3 white blood cells, 78 mm ESR, urinary sediment: less than 30/h.p.f. red blood cells. A new first-degree A-V block was detected. Blood cultures were negative. Due to persistent fever, progressive anemia, leukocytosis and new vegetations on echocardiogram, surgery was performed. A mitral valve ring abscess was found. Corynebacterium xerosis was isolated from surgical specimens. The strain was found susceptible to penicillin, ampicillin, oxacillin, ticarcillin, piperacillin, cephalotin, cefoxitin, cefoperazone, rifampin, gentamicin, amikacin, and norfloxacin. Studies with clindamycin, disclosed MIC and MBC = 0.25 mg/l. The patient received 1800 mg/day clindamycin for 4 weeks. Serum cidal studies showed a peak concentration 1/128 and a titre of trough 1/4. Negative control blood cultures were obtained. She has remained well for nine months after treatment. Corynebacterium sp. can cause "apparently" negative blood cultures. Blood samples should be incubated for more than 15 days before they can be considered negative. Almost 50% of previously described cases have been detected during the six months after cardiac surgery. Mortality has been high (48%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1986

Comparison between high and moderate doses of hydrocortisone in the treatment of status asthmaticus.

In a group of 40 adult patients in status asthmaticus, the responses to two different dosages of hydrocortisone were studied. All patients received a uniform treatment and were sequentially assigned to one of the following two groups: high dosage of hydrocortisone (80 mg/kg/day); or moderate dosage (6 mg/kg/day). The hydrocortisone was given intravenously in divided doses every six hours. The study lasted five days, and forced spirometry was performed daily at noon. The condition of all of the patients improved gradually, and when comparing both groups, no statistically significant differences were found in their spirometric measurements. We did not find any difference in the reversal of airway obstruction in the treatment of status asthmaticus by using a high dosage of hydrocortisone when compared with a lower moderate one.

Adult↗
PubMed1986

Recurrence of thymic hyperplasia after trans-sternal thymectomy in myasthenia gravis.

A 23-year-old woman with myasthenia gravis underwent thymectomy in September, 1975 by a trans-sternal approach for the removal of an hyperplastic gland. Surgical intervention was followed by marked improvement of her symptoms. Five years later, symptoms recurred. In March, 1982 diagnostic pneumomediastinum disclosed an anterosuperior mediastinal mass which, on excision, proved to be an hyperplastic thymus. This report confirms previous findings of thymus regrowth after surgery. It also demonstrates that surgical techniques using the trans-sternal approach do not guarantee complete removal of the thymus.

Adult↗