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Biomedical subjects

A J Salvatore

Publications and source records attributed to A J Salvatore.

5 recordsLinked to original sources
PubMed1999

[Spontaneous infectious spondylodiscitis in adults. Analysis of 30 cases].

We revised retrospectively 30 cases of Spontaneous Infectious Spondylodiskitis (SIS) in adults, diagnosed between 1986 and 1997. The mean age of the patients was 68.8 years; 56.7% were males. The identifiable causes were infectious endocarditis 13 (43.3%); tuberculosis 7 (23.3%); urinary tract infection 4 (13.3%); bacteremia with focus 2 (6.7%) and without focus 2 (6.7%). The cause was not identified in other 2 cases (6.7%). Infections were due to pyogenic bacteriae in 19 (63.3%); tuberculosis 6 (20%) and unknown 5 (16.7%). All patients had localized pain, 70% fever, 36.7% irradiated pain and 23.3% paraparesis. Fever was more frequent in patients with pyogenic etiology than in those with tuberculous SIS (p = 0.004). Blood cultures were positive in 70.4%. Percutaneous aspiration of the disc was performed in 13 patients; cultures were positive in 7. Causal germs were Streptococcus spp. 33.3%; Mycobacterium tuberculosis 20%; Staphylococcus spp. 16.6%; Escherichia coli 6.6%; Pseudomonas aeruginosa 6.6%. There was no bacteriological recovery in 5 (16.7%). Localization was lumbar in 18 (60%), dorsal in 8 (26.6%) and cervical in 4 (13.3%). X-ray of the spine was positive in 63.3% of the cases. Technetium scan in 90.5%, CT in 85.7% and MRI in 100% of cases in which it was carried out. All patients received antibiotic treatment with a median duration of 6 weeks for pyogenic SIS and one year for tuberculous SIS. Eighty three percent required immobilizing brace and 10% surgery for stabilization. Thirty six percent of patients presented complications, most of them related to the causal disease. There was a statistically significant association between mortality and diabetes.

Adult↗
PubMed1999

[Salami worker's lung].

Hypersensitivity pneumonitis (HP) is the clinical manifestation of an pulmonary immunological reaction to inhaled antigens. The list of provocative antigens and specific illnesses grows permanently. A woman of 56 years consulted for dyspnea and cough of two months of evolution. She worked in a factory of sausages removing the dust that recovers the salamis during their stationing. She presented hypoxemia and the pulmonary function test revealed a predominantly obstructive pattern. The x-ray of the thorax was normal and the high resolution computed tomography showed a mosaic pattern. A lung biopsy confirmed the diagnosis of HP. She improved with systemic corticosteroids and the avoidance of antigen exposure. In the cultures of the material that recovers the salamis, Penicillium spp. was recovered and was interpreted as the probable etiological agent of this HP, which we have denominated "the salami worker's lung".

Alveolitis, Extrinsic Allergic↗
PubMed1998

[The internist and ovarian cancer].

For the purpose of evaluating the role and participation of the internist in the diagnosis of Epithelial Ovarian Cancer (EOC), 81 medical records belonging to patients with EOC, were analyzed. The mean age of the patients was 63.5 years old (SD 12.33). Of these patients 21% were asked about their personal and familiar oncology history during their first office visit. Thirteen patients (16%) were asymptomatic in the first consultation. The more frequent symptoms were pain and abdominal distention. During this first examination, 46 patients (56.8%) presented some evident physical sign, and EOC was suspected in 35 patients (P = 0.00000004): the most frequent sign was an abdominopelvic mass in 34 patients (74%). Forty-six patients with EOC (56.8%) consulted an internist and twenty-four patients (29.6%) a gynecologist at first evaluation, without significant differences in diagnostic suspicion. Internists did not perform an abdomino-pelvic palpation. Gynecologists performed the abdomino-pelvic palpation in 74 patients, and 58 (78.4%) were found to be abnormal. The mean age of patients examined by internists was 68.2 years old, that is ten years older than the patients examined by gynecologists (P = 0.0007) and 70% were in Stages III and IV (P = 0.02). Gynecologists examined 9 asymptomatic patients (P = 0.0003) and 42% in Stages III and IV. The more frequent reasons for consultation to internists were abdominal pain (23 patients) and distention (17 patients). On the other hand metrorrhagia (9 patients) was the most common reason to consult a gynecologist. In conclusion, internists were frequent receptors of women with ovarian cancer at the first consultation. Their patients were older and with a more advanced disease stage. The interrogation concerning the oncology history was insufficient and the gastrointestinal symptoms were the most frequent cause for consulting an internist. The presence of some physical signs was associated with more diagnostic suspicion. The gynecologists examined more asymptomatic patients.

Family Practice↗