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A Nogués

Publications and source records attributed to A Nogués.

At least 19 recordsLinked to original sources
PubMed2005

Skin to calcaneus distance in the neonate.

BACKGROUND: Current recommendations for obtaining blood from neonates advise avoidance of the midline area of the heel and are based on postmortem studies. OBJECTIVE: Because of the potential pain and tissue damage from repeated heel pricking in the same area, to investigate using ultrasonography whether the distance from skin to calcaneus is less at the midline than at the borders. METHODS: One hundred consecutive healthy preterm and 105 consecutive healthy term neonates were studied 48-72 hours after delivery. The skin to perichondrium distance (SPD) was measured on two occasions by ultrasound at the external, midline, and internal areas of the heel. FINDINGS: Mean SPD was 0.2 mm less at the midline than at the other sites. The proportion of measurements <3 mm at any of the three sites was the same. Depth was <3 mm in less than 3% of the term and approximately 20% of the preterm infants. The SPD correlated only with gestational age. Of children <33 weeks gestational age, 38% had an SPD <3 mm compared with 8% of older preterm infants. The proportions of preterm infants of > or = 33 weeks gestation and term infants with an SPD <3 mm were similar (8% v 3%). INTERPRETATION: With the use of automated lancets of 2.2 mm length or less, the whole heel plantar surface is safe for obtaining blood in term and preterm infants of > or = 33 weeks gestation. This means that soft tissue damage and pain from repeated pricking in the same area can be reduced.

Anthropometry↗
PubMed2001

[Hepatitis C virus genotypes. Study of 302 patients coinfected by the human immunodeficiency virus].

BACKGROUND: To study the distribution of different HCV genotypes in HIV-infected patients. PATIENTS AND METHOD: This study was carried out in 302 HIV/HCV-coinfected patients who were followed-up at the HIV/AIDS Unit of the Arnau de Vilanova University Hospital of Lleida (Spain). HCV genotypes were determined by Inno-Lipa HCV II technique (Innogenetics, Belgium). RESULTS: 143 patients (51.43%) had a genotype-1, followed by genotype-3 (81 patients; 29.13%), genotype-4 (53 patients; 19.06%), and genotype-2 (one patient; 0.35%). It was not possible to know the genotype in 24 patients (NT). CONCLUSIONS: In our health care area, HCV genotype-1 was the commonest among HIV/HCV-coinfected patients. However, a given HIV-infected patient with HCV antibodies has practically the same probability of having a genotype-1 as a genotype non-1.

Genotype↗
PubMed2000

Community-acquired pneumonia: development of a bedside predictive model and scoring system to identify the aetiology.

Although initial presentation has been commonly used to select empirical therapy in patients with community-acquired pneumonia (CAP), few studies have provided a quantitative estimation of its value. The objective of this study was to analyse whether a combination of basic clinical and laboratory information performed at bedside can accurately predict the aetiology of pneumonia. A prospective study was developed among patients admitted to the Emergency Department University Hospital Arnau de Vilanova, Lleida, Spain, with CAP. Informed consent was obtained from patients in the study. At entry, basic clinical (age, comorbidity, symptoms and physical findings) and laboratory (white blood cell count) information commonly used by clinicians in the management of respiratory infections, was recorded. According to microbiological results, patients were assigned to the following categories: bacterial (Streptococcus pneumoniae and other pyogenic bacteria), virus-like (Mycoplasma pneumoniae, Chlamydia spp and virus) and unknown pneumonia. A scoring system to identify the aetiology was derived from the odds ratio (OR) assigned to independent variables, adjusted by a logistic regression model. The accuracy of the prediction rule was tested by using receiver operating characteristic curves. One hundred and three consecutive patients were classified as having virus-like (48), bacterial (37) and unknown (18) pneumonia, respectively. Independent predictors related to bacterial pneumonia were an acute onset of symptoms (OR 31; 95% CI, 6-150), age greater than 65 or comorbidity (OR 6.9; 95% CI, 2-23), and leukocytosis or leukopenia (OR 2; 95% CI, 0.6-7). The sensitivity and specificity of the scoring system to identify patients with bacterial pneumonia were 89% and 94%, respectively. The prediction rule developed from these three variables classified the aetiology of pneumonia with a ROC curve area of 0.84. Proper use of basic clinical and laboratory information is useful to identify the aetiology of CAP. The prediction rule may help clinicians to choose initial antibiotic therapy.

Adolescent↗
PubMed2000

Diagnosis of pneumococcal pneumonia by polymerase chain reaction (PCR) in whole blood: a prospective clinical study.

BACKGROUND: Streptococcus pneumoniae is the leading cause of community acquired pneumonia; however, only a small proportion of cases can be detected by conventional methods. The ability of the polymerase chain reaction (PCR) test performed on whole blood samples to identify patients with pneumococcal pneumonia was investigated. METHODS: One hundred and fourteen consecutive adult patients with community acquired pneumonia were evaluated by a wide battery of diagnostic tests in order to determine the aetiology. Blood samples from these patients and 50 controls were also tested by the nested PCR test to detect selected pneumolysin gene fragments of S pneumoniae. RESULTS: The patients were divided into four groups: (1) 40 patients with pneumococcal pneumonia in 22 of whom (55%) the PCR was positive (eight of 11 with bacteraemia and 14 of 29 without); (2) 30 with pneumonia due to other pathogens in all of whom the PCR was negative; (3) 44 with pneumonia of unknown aetiology in 14 of whom (32%) PCR was positive, and (4) 50 controls in whom the PCR test was positive in two (4%). Thus, the sensitivity of the test was 55% and the specificity 100% (81% if positive PCR tests among undiagnosed patients are considered as false positive results). CONCLUSION: PCR applied to whole blood samples appears to be a sensitive and very specific diagnostic test for identifying patients with pneumococcal pneumonia with a potential application in clinical practice.

Adolescent↗
PubMed1999

Is Streptococcus pneumoniae the leading cause of pneumonia of unknown etiology? A microbiologic study of lung aspirates in consecutive patients with community-acquired pneumonia.

PURPOSE: Although a wide variety of recognized pathogens can cause community-acquired pneumonia, in many patients the etiology remains unknown after routine diagnostic workup. The aim of this study was to identify the causal agent in these patients by obtaining lung aspirates with transthoracic needle aspiration. SUBJECTS AND METHODS: During a 15-month period, all consecutive patients with community-acquired pneumonia who were eligible for transthoracic needle aspiration were enrolled in the study. In addition to conventional microbial methods (culture of blood and sputum, serologic studies), we performed cultures and genetic and antigen tests for common respiratory pathogens in lung aspirates. RESULTS: The study group consisted of 109 patients. Conventional microbial studies identified an etiology in 54 patients (50%), including Mycoplasma pneumoniae in 19 patients, Chlamydia pneumoniae in 9 patients, and Streptococcus pneumoniae in 9 patients. Among the remaining 55 patients, study of the lung aspiration provided evidence of the causal agent in 36 (65%). In 4 additional patients with a single microbial diagnosis by conventional methods, the lung sample provided evidence of an additional microorganism. The new pathogens detected by lung aspiration were S. pneumoniae in 18 patients, Haemophilus influenzae in 6 patients, Pneumocystis carinii in 4 patients, and C. pneumoniae in 3 patients; other organisms were identified in 4 patients. CONCLUSIONS: In our study, S. pneumoniae was the leading cause of community-acquired pneumonia, accounting for 25% of all cases, including about one-third of the cases the cause of which could not be ascertained with routine diagnostic methods.

Adult↗
PubMed1998

Congenital chondromyxoid fibroma of the ethmoid: case report.

This report describes a congenital case of chondromyxoid fibroma (CMF) arising from the ethmoid bone. We believe it to be the second case of congenital CMF that has been documented, and the third case of CMF arising in the ethmoid. We describe the radiographic features of this rare entity and indicate the necessity for careful correlation between radiographic and histological findings to distinguish CMF from chondrosarcoma.

Chondroblastoma↗
PubMed1997

Rapid detection of pneumococcal antigen in lung aspirates: comparison with culture and PCR technique.

Detection of pneumococcal antigen has been used to increase the rate of diagnosis of pneumococcal pneumonia. The present study was designed to determine the value of rapid detection of pneumococcal antigen in samples obtained by transthoracic needle aspiration (TNA) from patients with community-acquired pneumonia (CAP) in a comparative analysis with culture and polymerase chain reaction (PCR). Pneumococcal antigen was detected by latex agglutination. One hundred and ten consecutive patients diagnosed with CAP underwent TNA. Patients were grouped, according to PCR, culture and serological results, into pneumococcal pneumonia (n = 18), other known aetiology (n = 67) and unknown aetiology (n = 25). In patients with pneumococcal pneumonia, antigen was detected in 17 (94.4%) cases. Antigen was detected in one and nine patients with pneumonia of other known or unknown aetiologies, respectively, yielding a specificity of 89.1%. In conclusion, detection of pneumococcal antigen on samples obtained by TNA from patients with CAP provides a sensitive and specific diagnosis of Streptococcus pneumoniae infection. Furthermore, its rapid results would reduce the dependence on empirical treatments.

Adult↗
PubMed1995

[Sensitivity of yeast isolates to amphotericin B and other antifungal inhibitors of beta-glucan synthesis].

BACKGROUND: Analysis of the in vitro sensitivity of clinical isolates of different yeast species to amphotericine B and two inhibitors of cell wall beta-glucane synthesis: the lipopeptide cilofungin and the liposaccharide papulacandin B, as well as the possible interactions among these antifungal types. METHODS: The in vitro sensibility of C. albicans strains and other yeast species of clinical origin was studied, using the macrodilution method in RPMI broth as recommended by NCCLS. In six C. albicans and two T. glabrata strains the interaction between amphotericine B and one of the beta-glucan inhibitors was also assessed, by combining one antifungal agent in a two-fold dilution series with subinhibitory concentrations (1/4MIC) of the second antifungal. RESULTS AND CONCLUSIONS: Of all three antifungals, amphothericine B proved to be the more active one, with a MIC90 of 1.25 micrograms/ml for C. albicans. MIC90 of cilofungin and papulacandine B is 5 micrograms/ml for both antifungals. The spectrum of action for the different yeast species is broader for papulacandin B than for cilofungin. On the other hand, no synergism has been observed between the two glucane inhibitors and amphotericine B.

Aminoglycosides↗
PubMed1995

[Evaluation of specificity of pneumococcal antigen detection in clinical samples by using the polymerase chain reaction as reference method].

BACKGROUND: Sensitivity and specificity of latex agglutination test on samples obtained by transthoracic needle aspiration was evaluated for diagnosis of pneumococcal pneumonia by using the polymerase chain reaction as reference method. METHODS: Samples from 29 patients with community acquired pneumonia were processed for culture, antigen detection and polymerase chain reaction. The latex agglutination test was performed with a reagents kit (Slidex méningite kit, BioMérieux, France) using the procedure recommended by the manufacturer. The polymerase chain reaction was carried out by using two primers: Pn2x up and Pn2x down that amplify the PBP2x gene of Streptococcus pneumoniae. RESULTS: Culture was positive in 5 patients, antigen detection in 15 and polymerase chain reaction in 14 patients. The specificity of latex agglutination test was 93% compared with polymerase chain reaction as reference method. CONCLUSION: The pneumococcal antigen detection by latex agglutination test is as sensitive as the polymerase chain reaction, it seems to be highly specific, and it is rapid and easy to perform.

Antigens, Bacterial↗
PubMed1993

Bacterial flora in the external ear canal and in induced cholesteatoma in the Mongolian gerbil.

We report on the bacterial flora of the external ear canal and of induced aural cholesteatoma in 14 Mongolian gerbils (Meriones unguiculatus). In the control, nonmanipulated external ear canal, gram-positive and gram-negative organisms were isolated. In the contents of the cholesteatoma sac, only monomicrobial, gram-negative isolates were found; in each animal they were different from the isolates from the nonmanipulated external ear canal. Obligate anaerobes were absent in all cases. Ligation of the external ear canal in the left ear provoked cholesteatoma in all cases.

Animals↗
PubMed1993

[Detection of Pneumocystis carinii in clinical samples by the polymerase chain reaction. Comparison with the methenamine silver technique].

BACKGROUND: A comparison of polymerase chain reaction (PCR) with methenamine silver stain was performed on clinical specimens for diagnosis of Pneumocystis carinii pneumonia in immunosuppressed patients. METHODS: 25 clinical samples (10 induced sputa, 12 transthoracic needle aspirations and 2 bronchoalveolar lavages) from 17 patients with AIDS and respiratory symptoms were studied. We performed DNA amplification by using 2 primers that amplify the mitochondrial large rDNA sequence of P. carinii. RESULTS: The sensitivity and specificity of the PCR technique were 92.8% and 100% respectively, with a positive predictive value of 100% and negative predictive value of 92.3%. The sensitivity of the silver stain were 65%, specificity 100%, positive predictive value 100% and negative predictive value 63%. CONCLUSION: The PCR technique is more sensitive than the methenamine silver stain for detecting Pneumocystis carinii in respiratory specimens from patients with pneumonia. Consequently it could be a very good alternative to classical methods in diagnosis of P. carinii infections.

AIDS-Related Opportunistic Infections↗
PubMed1993

[Acute toxoplasmosis. Laboratory diagnosis].

BACKGROUND: The microbiological diagnosis of acute toxoplasmosis in immunosuppressed patients, cannot, usually, be done through serological techniques. The methods for isolation or direct detection of parasite are the only ones that might be helpful to determine an earlier diagnosis, on these patients. METHODS AND RESULTS: The use of urine in 3 patients with acute toxoplasmosis, allowed us to isolate the parasite after inoculation of the sample in human embryonic fibroblast cell line (MRC-5). CONCLUSION: In our opinion urine could be an adequate sample for isolation or detection of Toxoplasma gondii in immunosuppressed patients, and an alternative to serological methods, as well.

AIDS-Related Opportunistic Infections↗
PubMed1991

[Fetal urinary dilatation due to vesico-ureteral reflux].

We have retrospectively studied 163 newborns referred to us between 1986 and 1990 for sonographic diagnosis of intra-uterine upper urinary tract enlargement. All were studied by paediatric radiologists on days 5th or 6th after birth by means of sonography and voiding cystourethrogram (VCU). Fifty percent had also IVP. No urinary tract disease could be found in 44 children, obstructive uropathy or cystic disease were diagnosed in 58 children and 61 patients had vesico-ureteric-reflux (VUR). They form the basis of the present report. There was a male-to-female ratio of 3.3 to 1. Neonatal ultrasonography was normal in 11 cases, 42 had pyelectasia (bilateral in eight cases) and eight had ureterohydronephrosis (bilateral in seven). VUR was bilateral in 28 cases, right in 16 and left in 17. Out of the 89 refluxing units, VUR grade was I in 11, II in 16, III in 24, IV in 14 and V in 23. There was intra-renal reflux in 17 units. Some other form of urinary tract disease was detected in 29 babies (47.5 per 100). Twenty-eight patients were operated upon and the remaining are under long-term urinary antisepsis with only five episodes of infection. The considerable proportion of false negatives for VUR in neonatal ultrasonography (30 per 100) and the high grade of some of these cases lead us to strongly advise routine VCU for patients with intra-uterine urinary tract dilatation.

Dilatation, Pathologic↗
PubMed1991

[Warren's shunt in the treatment of portal hypertension in children].

Portal hypertension (PH) is often of extrahepatic origin in children. Several approaches have been proposed for its management: Observation, endosclerosis, devascularization and portosystemic shunting. Only the latter has an adequate haemodynamic rationale but the surgical risks, the fear of later portal deprivation encephalopathy and the difficulties of performing technically satisfactory anastomosis have discouraged many surgeons. Warren's distal spleno-renal shunt, selectively decompress esophageal varices and cures hypersplenism while sparing the spleen and providing a high flow anastomosis. We have used this operation in three patients with extrahepatic PH. All patients ceased bleeding and had their spleen size reduced with normal function.

Adolescent↗
PubMed1989

Giant spontaneous duodenal hematoma in hemophilia A.

A 12-year-old hemophilic boy was admitted because of acute abdomen with intraabdominal bleeding. The cause was a giant intramural duodenal hematoma that resolved after 16 days of parenteral nutrition. This condition is a rare complication of coagulation disorders, but it should be suspected in cases with internal blood loss. Abdominal ultrasonography, computed tomography scans, and contrast x-ray studies are diagnostic procedures for such cases.

Child↗
PubMed1988

[Primary vesicoureteral reflux. I: Renal growth in kidneys without pyelonephritis].

We have studied renal growth in 133 children with 195 refluxing ureters (VUR). Average follow-up was 38 (range 12-84) months. Low grade VUR (I-III) were more frequent and left-sided ones predominated among unilateral cases. There was a clear correlation between VUR grade and the presence of reflux nephropathy (RN). Seventy percent of low-grade VUR cured under long-term urine disinfection, whereas surgery was successful in 97.5% of high-grade, often scarred, units. Recurrent urinary infections after cure of VUR were equally frequent in both groups. The growth of the 140 unscarred refluxing kidneys was evaluated by means of renal length, corticorenal index and growth speed measurements. All values remained within ranges considered statistically undistinguishable from those of normal kidneys. Our findings confirm that, in our conditions of treatment, VUR without RN does not impair renal growth for the period of time studied.

Child↗