PubMed Health⌕ Search

Biomedical subjects

A Pahissa

Publications and source records attributed to A Pahissa.

At least 19 recordsLinked to original sources
PubMed1992

[Psoas abscess: diagnostic and therapeutic usefulness of echography and computerized tomography].

BACKGROUND: Psoas abscess (PA) is a clinically infrequent entity. The abscess may form spontaneously (primary PA) or as a complication of contiguous infection (secondary PA). The use of ultrasonography (US) and computerized tomography (CT) facilitates diagnosis and treatment of a disorder which previously required surgery. METHODS: Nineteen cases of PA diagnosed over the last 7 years were retrospectively studied. Confirmation of diagnosis was established by exteriorization of pus with US, CT or during surgery. RESULTS: Three primary PA (16%) and 16 secondary PA (84%) were diagnosed. The foci of origin of the secondary PA were: urologic (50%), rachydeal (25%), gastrointestinal (12.5%) and iatrogenic lumbar infection (12.5%). The most frequent germs in the primary PA were: Staphylococcus aureus (67%) and in the secondary PA, enterobacteriae (50%). The diagnostic profitability of US was 41% (7/17) and for CT was 100% (15/15). Percutaneous drainage was performed in 9 patients which failed in 2 cases due to compactness of pus (22%) and in another 2 because of undiagnosed osteomyelitis (22%). Two patients (10%) with underlying disease died despite adequate medical-surgical treatment. CONCLUSIONS: Psoas abscess were secondary in 84% of the patients studied with most being due to enterobacteriae. The diagnostic profitability of computerized tomography was greater than that of ultrasonography (100% vs 41%). Percutaneous drainage is a valid therapeutic alternative. Relapse observed in this study was due to previously undiagnosed osteomyelitis.

Adolescent↗
PubMed1992

Value of differential quantitative blood cultures in the diagnosis of catheter-related sepsis.

A prospective study was performed to assess the value of differential quantitative blood cultures in the diagnosis of catheter-related sepsis when this condition is suspected on clinical grounds and to establish a reliable discriminative value for application without removal of the inserted catheter. A total of 107 central venous catheters from 64 patients were used for the study. Blood was obtained simultaneously through the suspected infected device and from a peripheral venipuncture. The catheter was removed and its tip cultured semiquantitatively. Catheter-related sepsis occurred in 17 patients. Using as cut-off value a colony count fourfold higher in blood drawn through the catheter than in simultaneously drawn peripheral blood, a sensitivity of 94%, specificity of 100% and positive predictive value of 100% were obtained. A single bacterial count greater than 100 cfu/ml in the quantitative culture of the catheter blood specimen in the presence of a positive qualitative peripheral blood culture of the same organism was also highly suggestive of catheter-related sepsis. Differential quantitative blood culture is a reliable method for the diagnosis of catheter-associated sepsis without catheter removal.

Bacteremia↗
PubMed1990

[Infectious endocarditis in drug addicts: a study of 71 cases].

Infective endocarditis (IE) is a severe and relatively common condition in parenteral drug abusers (PDA). Seventy-one IE episodes in 59 PDAs admitted to the Hospital General Vall d'Hebron from August 1978 to December 1988 were evaluated. The disease basically involved young males, with a progressively increasing incidence throughout the decade and a higher frequency during August. Fever was a constant symptom, with a duration of less than 10 days before admission in 73% of cases. Staphylococcus aureus was the most common pathogen (85% of episodes). Vegetations were detected by echocardiography in 70% of cases. In 82% of episodes the right side of the heart was involved, particularly the tricuspid valve. The initial chest X-ray film was abnormal in 57.5% of episodes. In 7 patients features of heart failure were present at admission; most had left heart endocarditis. Three patients with left heart endocarditis required surgical therapy. Overall mortality was 13%; it was 6% in patients with only tricuspid involvement and 27% when the left heart was involved.

Adolescent↗
PubMed1990

[Infections in 96 cases of systemic lupus erythematosus].

The incidence, localization, etiology and predisposing factors of infections were evaluated in 96 cases of systemic lupus erythematosus (SLE) (15 males and 81 females) with a mean age of 40 years. Fifty-three patients (55%) had overall 102 infections (incidence 0.17 per year). 31% had urinary tract infections. In these, Escherichia coli was the most common causative organism (56%). 25% had respiratory infections (pneumonia in 14, pulmonary tuberculosis in 8, infections by opportunistic organisms in 4). 17% had skin infections, of which one half were due to Staphylococcus aureus. 16% had bacteremia, due to Staphylococcus spp in 5, to Salmonella spp in 4, and to Pseudomonas aeruginosa in 3. There was a higher incidence of infections in patients with active SLE, in those with nephropathy, and in those with previous immunosuppressant and/or corticosteroid therapy, Leukopenia was not associated to a higher number of infections. In 6 of the 12 patients who died, death was directly related with the infection; in one half of them, infections were due to an opportunistic organism (cytomegalovirus in 2 cases, disseminated candidiasis in one) and were not identified until necropsy. The need to rule out an opportunistic infection in any patient with SLE and fever is emphasized, particularly when there is pulmonary involvement and the patients have undergone aggressive diagnostic and/therapeutic interventions (immunosuppressants, plasmapheresis, renal dialysis).

Adolescent↗
PubMed1990

[Bacteremia and fungemia in patients with AIDS. Study of 56 episodes].

We report 56 episodes of bacteremia and fungemia in 45 patients (23%) out of overall 193 cases of AIDS. 41% of the isolates were gram-negative bacilli, with a predominance of Salmonella enteritidis (30%), most of them community-acquired. Gram-positive cocci (18 episodes) were hospital-acquired in 61%, with a predominance of Staphylococcus sp (10 cases). Mycobacteria and Cryptococcus neoformans were isolated in 8 patients. 88.8% of our patients with cryptococcosis (8/9) had positive blood cultures. 76% of the episodes (43/56) were community-acquired, with a high incidence of primary bacteremias (59%). 48% of the patients were cured, whereas 27% died from causes related with the bacteremia.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Adenosine deaminase activity in rheumatoid pleural effusion.

The activity of adenosine deaminase was studied in nine cases of rheumatoid pleural effusion, showing an increase in enzyme activity in all. Rheumatoid arthritis seems unique, however, as it cannot be differentiated from pleural tuberculosis on the basis of this test. Selective increase of adenosine deaminase in both conditions is attributed to stimulation of T lymphocytes in the pleural fluid.

Adenosine Deaminase↗