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Biomedical subjects

A Peris

Publications and source records attributed to A Peris.

At least 19 recordsLinked to original sources
PubMed2005

Seroprevalence of varicella among children and adolescents in Valencia, Spain. Reliability of the parent's reported history and the medical file for identification of potential candidates for vaccination.

This study assessed the seroprevalence of varicella antibodies in children and adolescents in Spain and evaluated the reliability of two methods for detecting susceptible individuals: (1) parental-reported history of varicella and (2) medically-documented histories maintained by the pediatrician. A total of 186 children (6 to 15 years of age) were recruited in 13 pediatric offices of Valencia, Spain. A brief case report form was completed including previous history of varicella referred by the parents, and a 5 mL blood sample was obtained. The pediatrician medical file was reviewed for antecedent of varicella. The overall prevalence of varicella antibodies was 84% and 88% in the 6-9 years and 10-15 years age brackets, respectively. The predictive value of a negative history of varicella disease was 48% by parental recall (52% "false negative"), and only 26% by medical record (74% "false negative"). However, the positive predictive value of a positive parental reported history or a positive medically-documented history was 95%. The most effective strategy for varicella vaccination of older children and adolescents in Spain will be to immunize those individuals with a lack of positive (unknown or negative) history of disease.

Adolescent↗
PubMed2004

Iron lung versus conventional mechanical ventilation in acute exacerbation of COPD.

The aim of this randomised study was to compare the effects of iron lung ventilation (ILV) with invasive mechanical ventilation (IMV) in patients with acute respiratory failure (ARF) due to exacerbation of chronic obstructive pulmonary disease. Forty-four patients with ARF were assigned either to ILV (22 patients) or IMV (22 patients). Primary end-points were the improvement in gas exchange and complications related to mechanical ventilation. On admission ILV and IMV groups did not differ in age, simplified acute physiology score II, arterial oxygen tension (Pa,O2)/inspiratory oxygen fraction (FI,O2), arterial carbon dioxide tension (Pa,CO2) and pH. Compared with baseline, ILV and IMV induced a similar and significant improvement in Pa,O2/FI,O2, Pa,CO2 and pH after 1 h of treatment and at discontinuation of mechanical ventilation. Major complications tended to be more frequent in patients treated with IMV than in those treated with ILV (27.3% versus 4.5%), whereas mortality rate was similar (27.3% versus 18.2%). The ventilator-free days and the length of hospital stay were significantly lower in the ILV than in the IMV group. This study suggests that iron lung ventilation is as effective as invasive mechanical ventilation in improving gas exchange in chronic obstructive pulmonary disease patients with acute respiratory failure, and is associated with a tendency towards a lower rate of major complications.

Acute Disease↗
PubMed2001

Cardiac contusion in blunt chest trauma: a combined study of transesophageal echocardiography and cardiac troponin I determination.

BACKGROUND: The role of cardiac troponin I (cTnI) is well established in acute myocardial ischemia. However, its role in myocardial contusion remains to be clarified. Since transesophageal echocardiography (TEE) appears, at present, to be the best method for the diagnosis of myocardial contusion, the aim of this study was to measure the concentration of cTnI in patients with blunt chest trauma studied using TEE. METHODS: Thirty-two patients (27 males, 5 females, mean age 44+/-20 years), admitted to the Trauma Center of our Institution with clinical and/or radiological signs of acute blunt chest trauma, underwent biplane TEE within 24 hours of injury; serial blood samples were taken to measure cTnI levels (normal values < 0.4 ng/ml), using fluorimetric enzyme immunoassay. RESULTS: Abnormal levels of cTnI were found in 17 patients (53%): 7 patients had levels of cTnI between 0.4 and 1 ng/ml, whereas 10 patients had levels > 1 ng/ml. Segmental wall motion abnormalities consistent with myocardial contusion could be identified by echocardiography in 6/10 patients with cTnI levels > 1 ng/ml (60%) but in no patients with normal cTnI levels or with titers between 0.4 and 1 ng/ml; mean cTnI levels showed a significant difference between the two groups of patients with and without echocardiographic signs of myocardial contusion (2.6+/-1.6 vs 0.6+/-1.4 ng/ml, p < 0.001). CONCLUSIONS: Abnormal titers of cTnI suggesting myocardial contusion may be found in more than half of patients with blunt chest trauma; however, myocardial injury can be detected by TEE only for cTnI levels > 1 ng/ml; cTnI concentrations ranging between 0.4 and 1 ng/ml might be indicative of myocardial microlesions, not detectable by echocardiography, even if TEE is used; cTnI assay could therefore be suggested as a screening test before performing TEE after blunt chest trauma.

Adult↗
PubMed1998

Negative pressure ventilation versus conventional mechanical ventilation in the treatment of acute respiratory failure in COPD patients.

This case-control study was aimed to evaluate the effectiveness of negative pressure ventilation (NPV) versus conventional mechanical ventilation (CMV) for the treatment of acute respiratory failure (ARF) in patients with chronic obstructive pulmonary disease (COPD) admitted to a respiratory intermediate intensive care unit (RIICU) and four general intensive care units (ICU). Twenty-six COPD patients in ARF admitted in 1994-95 to RIICU and treated with NPV (cases) were matched according to age (+/-5 yrs), sex, causes triggering ARF, Acute Physiology and Chronic Health Evaluation (APACHE) II score (+/- 5 points), pH (+/-0.05) and arterial carbon dioxide tension (Pa,CO2) on admission with 26 patients admitted to ICU and treated with CMV (controls). The primary end points of the study were inhospital death for both groups and the need for endotracheal intubation for cases. The secondary endpoints were length and complications of mechanical ventilation and length of hospital stay. The effectiveness of matching was 91%. Mortality rate was 23% for cases and 27% for controls (NS), five cases needed endotracheal intubation, four of whom subsequently died. The duration of ventilation in survivors was significantly lower in cases than in controls, with a median of 16 h (range 2-111) versus 96 h (range 12-336) (P<0.02), whereas the length of hospital stay was similar in the two groups, with a median of 12 days (range 2-47) for cases vs 12 days (range 3-43) (NS) for controls. No complications were observed in cases, whereas three controls developed infective complications. These results suggest that negative pressure ventilation is as efficacious as conventional mechanical ventilation for the treatment of acute respiratory failure in patients with chronic obstructive pulmonary disease and that it is associated with a shorter duration of ventilation and a similar length of hospital stay compared with conventional mechanical ventilation.

Acute Disease↗
PubMed1997

[Quality and life style as risk factors in acute cerebrovascular disease].

INTRODUCTION: In some series of patients with acute cerebral vascular disease (CVD) it has been seen that, prior to the episode of CVD, the patients already had a poorer quality of life than other people of their age. The object of this study is to evaluate their previous life style and quality of life as risk factors (RF) in acute CVD. MATERIAL AND METHODS: A case-control study was done of a total of 151 patients admitted to two hospitals with acute CVD and 151 persons, who were not hospitalized and acted as the control group, paired (one to one) for age, sex and hospital. In both groups data were collected regarding basic general health, previous quality of life (Nottingham Health Profile-NHP-, life style and self-perception of social support. The relative risks were estimated by calculating the odds ratios and conditional logistic regression. RESULTS: Regular moderate physical exercise acts as a protective factor with an OR of 0.32 (IC 95%: 0.14-0.76). Consumption of tobacco and alcohol increased the risk of CVD but did not reach statistical significance. No relationship was found between perceived social support and risk of CVD. Physical mobility, evaluated using the NHP showed a statistically significant negative association with acute CVD (OR: 0.32; IC 95%: 0.14-0.71). CONCLUSIONS: Our results seem to suggest that the previous overall quality of life cannot be considered a RF in acute CVD, except for physical mobility as evaluated on the NHP. Reduction of this constitutes a RF and moderate physical exercise behaves as a protective factor.

Acute Disease↗
PubMed1997

[Stressful life events as risk factors in acute cerebrovascular disease].

INTRODUCTION: The influence of psychosocial stress on the origin of acute cerebral vascular disease (CVD) has received very little attention. The objective of this paper is to evaluate the role of psychosocial stress due to events occurring in daily life as a risk factor (RF) in acute CVD. MATERIAL AND METHODS: A case-control study was done of a total of 151 patients who were admitted to two hospitals with acute CVD and 151 persons, who where not hospitalized and acted as the control group, paired (one to one) for age, sex and hospital. In both groups data were collected regarding basic general health, consumption of tobacco and alcohol and stressful incidents (SI) in their lives during the previous two years. The stress derived from SI was measured on the 'Inventory of SI and Recent Experiences' of Holmes and Rahe. The frequency of serious SI was also considered. The relative risks were estimated by the odds ratio calculations. RESULTS: A positive association was found for the RF defined in relation to acute CVD. We did not find any relationship between psychosocial stress derived from SI and risk of acute CVD (either when considering scores on the Holmes and Rahe Inventory or evaluation of serious SI). CONCLUSIONS: Psychosocial stress from SI does not seem to represent a RF in acute CVD.

Acute Disease↗
PubMed1995

[Spontaneous bacterial peritonitis due to Listeria monocytogenes].

We present a case of spontaneous bacterial peritonitis (SBP) caused by Listeria monocytogenes in a patient previously diagnosed as alcoholic liver cirrhosis. The clinical presentation, biochemical data and outcome of the patient are compared with those of cases of SBP caused by Listeria monocytogenes in patients with cirrhosis published in the Spanish and English literature. Twelve out of 20 cases described in the literature were published by Spanish authors. This greater proportion could be related to dietary habits (greater consumption of fruits and vegetables), climatic or demographic factors. We underline the importance of pursuing a microbiological diagnosis since Listeria monocytogenes is intrinsically resistant to cefotaxime, the antimicrobial often selected to empirically treat SBP episodes.

Ascitic Fluid↗
PubMed1994

Modification of concentration-response curves to inhaled methacholine after the pollen season in subjects with pollen induced rhinitis.

BACKGROUND: The effect of cessation of exposure to pollen on the concentration-response curves to inhaled methacholine was investigated. METHODS: Methacholine inhalation challenges (up to 200 mg/ml) were performed in 13 non-asthmatic patients with grass and/or Parietaria pollen-induced rhinitis during the pollen season, and one and four months after it. Concentration-response curves were characterised by their PC20, position, and plateau. RESULTS: Geometric mean methacholine PC20 increased from 6.4 mg/ml during the pollen season to 28.2 mg/ml and 54.9 mg/ml one and four months after the end of season, respectively. The mean (SE) level of the plateau decreased from 30.5 (4.3%) in the pollen season to 23.3 (3.7)% and 20.1 (3.3)% one and four months after the end of pollen season, respectively. Although the methacholine concentration that produced 50% of the maximal response increased from 2.9 mg/ml to 4.3 mg/ml and 6.0 mg/ml, the differences were not significant. CONCLUSIONS: In non-asthmatic patients with pollen-induced rhinitis cessation of exposure to pollen is associated with significant modifications in the methacholine threshold value and level of plateau, and with a small shift in the concentration-response curves to the right.

Adult↗
PubMed1993

Isolation by mAb based affinity chromatography of two Par j I isoallergens. Comparison of their physicochemical, immunochemical and allergenic properties.

We report the identification and separation of two isoallergen components of Par j I, the major allergen from Parietaria judaica pollen. First, electrophoretic conditions for consistently separating both isoforms in an SDS-PAGE system were established, and mol. wt values of 13,000 (isoallergen IA) and 10,500 (isoallergen IB) were estimated. Immunoblot, after SDS-PAGE experiments, with individual P. judaica-sensitive human sera revealed a slightly different IgE-binding pattern for each isoallergen. Four anti-Par j I mAbs were obtained from BALB/c mice immunized with a purified Par j I preparation comprising IA and IB isoallergens. Three mAbs were directed to an epitope shared by both isoallergens, and the fourth one recognized specifically one epitope on Par j IB. Dot-blot experiments with the deglycosylated allergen showed that the mAbs did not recognize the carbohydrate prosthetic group of the molecules. Affinity chromatography using the mAbs allowed the separation of the isoallergens that retained their IgE-binding ability after the purification process. Amino acid composition analyses and partial N-terminal sequencing demonstrated an extensive homology and also the existence of some structural differences between Par j I isoallergens, which is in agreement with the high, but not complete, cross-reactivity observed in competition ELISA experiments. Finally, skin prick tests performed on 28 P. judaica-sensitive patients showed that all of them recognized both isoforms and that allergenic epitopes present in Par j IA and IB are responsible for most of the allergenic activity of the whole extract.

Allergens↗
PubMed1993

Modifications of PC20 and maximal degree of airway narrowing to methacholine after pollen season in pollen sensitive asthmatic patients.

We examined the effect of cessation of exposure to pollen on non-specific airway responsiveness in 10 grass and/or parietaria pollen sensitive asthmatics. Three methacholine inhalation challenges were performed, the first during pollen season (seasonal period), the second 2 months after the end of season (short time after seasonal period), and the third 5 months after the end of season (long time after seasonal period). The dose-response curves to methacholine were characterized by the PC20 (provocative concentration of methacholine required to produce a 20% fall in FEV1) and maximal response plateau, if possible. A maximal response plateau on the dose-response curve was considered to be present if three or more data points for FEV1 fell within a 5% response range. The challenge was stopped when FEV1 dropped more than 50% or the highest concentration of methacholine (200 mg/ml) was reached. The geometric mean (range) methacholine PC20 increased from 1.08 (0.18-37.22) in the seasonal period to 4.67 (0.71-200) mg/ml during the long time after seasonal period (P < 0.01). On the other hand, in six subjects in whom it was possible to obtain a plateau on at least one challenge, the level of the maximal response decreased from (mean +/- s.e.m.) 44.1 +/- 4.9 in the seasonal period to 30 +/- 4.4 during the long time after seasonal period (P < 0.05). These results suggest that in pollen sensitive asthmatic patients, the cessation of exposure to pollen is associated with a reduction of non-specific bronchial responsiveness (PC20 and maximal degree of airway narrowing to methacholine).

Adolescent↗
PubMed1992

[Quality of life in arterial hypertension].

BACKGROUND: Quality of life is a key issue for the consideration of hypertension therapy. However, reliable and sensitive evaluation methods are not available in Spain. To this end, a quality of life questionnaire has been elaborated, its yield has been evaluated, and the influence of hypertension and several associated variables on the quality of life has been assessed. METHODS: A questionnaire on quality of life consisting of 62 items was elaborated. Its final evaluation was divided in an overall value and in four subindexes related with anxiety, depression, side effects, and somatic complaints. It was applied to two groups of hypertensive patients, one from hospital care (n = 90) and another from primary care (n = 89), and to a control group (n = 76). RESULTS: Although both populations with hypertension were significantly different regarding age, sex, use of therapies, organic impact and blood pressure, they were overall similar in quality of life. However, quality of life was different from that in control group, which showed better indices. In the hypertensive population, sex, severity of hypertension, type of therapy or duration of the disease did not have any influence on quality of life. CONCLUSIONS: The overall similar quality of life in both hypertensive groups (in spite of the many significant differences in their descriptive features) and the different quality of life between hypertensive and normotensive individuals (in spite of the similitude of their demographic parameters) suggest that the diagnosis of hypertension has by itself a greater influence on the quality of life than several hypertension-associated variables. It has also been found that the method used was sensitive and valid. Therefore, the use of the quality of life questionnaire can be a useful instrument for the monitorization of hypertensive patients.

Adult↗
PubMed1992

[Peritoneal pneumococcal infections].

The clinical-microbiological characteristics of 13 patients iun whom Streptococcus pneumoniae (Pneumococcus) was isolated from the peritoneum over eight and a half years in a third grade hospital are reviewed. It is noteworthy the fact that only in 7 cases primary or spontaneous peritonitis were treated; the remaining cases were secondary to perforation or genital infection in females. The presence of antibiotic resistance in pneumococcus was high and global mortality was low.

Adolescent↗
PubMed1992

[Human genital myiasis due to Sarcophaga].

Human myiasis are infestations produced by fly larvae which invade human tissues or cavities. We report a case of semi-specific myiasis which consisted in infestation of the vulvar region of an eighty-six-year old, diabetic patient who was admitted in a clinical center for elderly. The development from larva to adult fly was carried out in the laboratory and it was identified as Sarcophaga. The infestation was resolved extracting the larvae and washing the affected area with an antiseptic solution.

Aged↗