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Bernardino Roca

Publications and source records attributed to Bernardino Roca.

At least 19 recordsLinked to original sources
PubMed2006

[Lyme borreliosis].

Lyme borreliosis is a zoonotic disease transmitted by ticks and caused by the spirochete Borrelia burgdorferi. There are cases of the infection reported at least since the beginning of last century, although a complete description of the disease is available only since 1982. Clinical presentation consists generally of a characteristic skin rash, known as erythema migrans, and a variety of systemic manifestations, which evolve in stages, along months to years. Diagnosis is usually made with serology tests, and the infection responds well to several antibiotics, especially if given in the early stages of the disease.

Humans↗
PubMed2006

Presentation and outcome of infective endocarditis in Spain: a retrospective study.

OBJECTIVE: To analyze cases of infective endocarditis in patients who attended the Hospital General de Castellón, Spain, between 1999 and 2004. METHODS: This was a retrospective study. Demographic and clinical characteristics were assessed, variation in presentation over time was analyzed, and factors influencing outcome were determined. RESULTS: A total of 54 cases in 48 patients were included; 33 (61%) were in men. The median patient age was 62 years. Infective endocarditis occurred on a native valve in 36 cases (67%), a mechanical prosthetic valve in 12 (22%), and a pacemaker in six (11%). The mitral valve was the most commonly affected site. Transthoracic and/or transesophageal echocardiography showed a vegetation in 45 (83%) cases, moderate or severe valvular regurgitation in 27 (50%), and intracardiac destructive lesions in five (9%). The outcome in 15 (28%) cases was death, and multivariate analysis disclosed significantly increased risk of death associated with older age, lower serum albumin, and higher white blood cell count. CONCLUSIONS: This study confirmed the protean nature of infective endocarditis, and identified several factors predictive of mortality including advanced age, low serum albumin, and high white blood cell count.

Adult↗
PubMed2006

Tuberculous meningitis presenting with unusually severe hyponatremia.

We report a patient with tuberculous meningitis who presented with unusually severe hyponatremia, an electrolyte disorder that may cause symptoms similar to those of tuberculous meningitis. The hyponatremia was probably due to the syndrome of inappropriate antidiuretic hormone secretion, and resolved after instituting water restriction and antituberculous medication.

Adult↗
PubMed2005

HAART with didanosine once versus twice daily: adherence and efficacy.

BACKGROUND: Highly active antiretroviral therapy (HAART) containing didanosine taken twice daily was compared with HAART containing didanosine taken once daily in terms of adherence and efficacy. METHOD: This was a self-controlled prospective cohort study, carried out in a tertiary level hospital. A total of 49 HIV-infected patients were included. They were prescribed HAART according to guidelines. After six months taking HAART containing didanosine twice daily, patients continued with the same regimen of HAART although once daily. Thereafter they were followed up for a further nine months. Adherence and virological efficacy were assessed at three-month intervals, for a total of six times, in every patient. RESULTS: Overall, adherence was poor, with only 19 patients (39%) showing adequate adherence for all six visits. Adequate adherence was observed in 29 patients (59%) three months before didanosine switching, and in 37 patients (75%) three months after didanosine switching (P=0.034). Pooled HIV RNA results of the first three visits were higher than the same results of the last three visits (P=0.05). CONCLUSIONS: Non-adherence is common among patients who take HAART. Simplification of regimens is useful to improve adherence and efficacy.

Adult↗
PubMed2005

Intradural extramedullary tuberculoma of the spinal cord: a review of reported cases.

Intradural extramedullary tuberculoma of the spinal cord (IETSC) is a rare modality of tuberculosis, with only a few cases described so far. Here we review 22 reports of the disease found in the literature of the last 25 years. IETSC is closely associated with tuberculous meningitis (TM). Both conditions may occur simultaneously, but more frequently IETSC is preceded by TM. IETSC has been described in a predominantly young population of both genders. The pathogenesis is unknown, although a paradoxical reaction to antituberculous medication is a reasonable possibility. The disease presents insidiously with paraparesis, hypoesthesia with a sensory level, and bladder dysfunction, due to cord involvement or compression by the inflammatory process. Permanent paraparesis is a common sequela. MRI is the diagnostic technique of choice in IETSC. Prompt surgical excision of the tuberculoma is the cornerstone of therapy. Antituberculous treatment is also indicated; unless resistance is present, conventional chemotherapy is probably enough. Corticosteroids are also generally recommended. In conclusion, IETSC is a rare complication of TM, which presents insidiously, despite adequate antituberculous treatment. To avoid the permanent disability that this condition may provoke, an early diagnosis and prompt treatment is critical.

Adolescent↗
PubMed2005

Primary non-hodgkin lymphoma of the larynx.

A rare case of primary large B-cell non-Hodgkin lymphoma of the larynx is reported. The patient was an 80-year-old female who presented with pharyngeal discomfort and dysphagia. Radiotherapy was instituted with complete remission of the tumor. Nine months afterward, she presented with aspiration pneumonia and dysphagia. Indirect laryngoscopy disclosed laryngeal and esophageal edema, which was probably related to radiotherapy. No signs of tumor recurrence were observed. Three months later, she was entirely asymptomatic. Although cases of aggressive course and poor response to therapy exist, primary large B-cell non-Hodgkin lymphoma of the larynx is generally considered a relatively benign and radiosensitive tumor.

Aged↗
PubMed2005

Miliary tuberculosis in a patient with eosinophilic fasciitis.

The fibrosing disorders represent a diverse group of uncommon chronic diseases that include systemic sclerosis, eosinophilic fasciitis, eosinophilia-myalgia syndrome, toxic oil syndrome, and localized forms of fibrosis. A rare case of eosinophilic fasciitis is reported. The patient was a 61-year-old female who presented with generalized massive edema and eosinophilia. Signs of common edema-producing diseases, such as heart failure, were absent. Corticosteroids were initiated with slow improvement in edema. Over the ensuing months, miliary tuberculosis and tenosynovitis of her left hand and left foot developed, which responded to appropriate treatment. Moreover, prominent induration, hyperpigmentation, and coarse puckering of the skin gradually took place. Other conditions, especially neoplasms and infections, have been described in association with eosinophilic fasciitis, but this is the first reported case of miliary tuberculosis associated with the disease.

Eosinophilia↗
PubMed2005

[Changing trends in HIV epidemics: recent diagnoses in the Spanish VACH cohort (2000-2002)].

BACKGROUND: Studying the changing trends of HIV epidemics is a useful means of evaluating the results of current preventive plans as well as of defining future needs and objectives. METHODS: We performed a cross-sectional study of the newly-diagnosed cases of HIV infection included in the Spanish VACH cohort. New HIV cases were defined as those diagnosed between January 2001 and December 2002. Their epidemiologic characteristics were compared with those of patients included in the same cohort who had been diagnosed between January 1998 and December 2000. RESULTS: We studied 603 new cases (27% women). In 146 (24.4%) HIV infection had been acquired by sharing material for intravenous drug use (IVDU), 171 (28,6%) were men who had had sex with other men (MSM) and 247 (41.3%) acknowledged some risk for heterosexual HIV transmission. The median age was 36 years (range: 18-80). Only 1.5% of the patients were younger than 20 years while 32.1% were older than 40 years. This percentage was significantly higher than that corresponding to 1998-2000 (27.5%; p < 0,05). HIV infection was diagnosed simultaneously with an AIDS-defining condition in 13.3% of patients and an AIDS-defining disease was diagnosed in the first month after HIV-diagnosis in another 40 patients (6.6%). CONCLUSIONS: We confirm the trends observed in previous studies: a growing proportion of newly diagnosed cases among women, a decreasing proportion of IVDU, a growth of MSM, and a trend toward diagnosis at a later age.

AIDS-Related Opportunistic Infections↗
PubMed2004

[Predictors of progression and death in patients with advanced HIV infection in the era of highly active antiretroviral therapy].

INTRODUCTION: To assess the factors associated with progression of infection and death in HIV-positive patients with severe immunodepression in the era of highly active antiretroviral therapy (HAART). METHODS: We studied 146 HIV-infected patients with < 100 x 10(6)/L CD4+ lymphocytes and positive cytomegalovirus (CMV) serology enrolled between December 1997 and October 1998 and prospectively followed a median of 12.1 months. The main outcome measures were progression of HIV infection, defined as the appearance of a new AIDS-defining disease (CDC category C) or death. HIV viral load, lymphocyte count (CD4+ and CD8+), HAART administration and other clinical variables were evaluated at baseline. CMV viremia (determined by PCR) and HAART efficacy were recorded during follow-up. RESULTS: Progression was observed in 40% of patients and 17% died. Factors associated with progression or death were CD4+ lymphocyte count less than 50 x 10(6)/L, CD8+ lymphocyte count less than 500 x 10(6)/L, HIV viral load more than 300,000 copies RNA/mL, CMV viremia, and absence or inefficacy of HAART. In the multivariate model, absence of HAART and low CD4+ and CD8+ counts remained statistically associated with progression, but the only variable associated with death was CMV viremia. CONCLUSIONS: In patients with advanced HIV infection, CD4+ and CD8+ cell count and HAART were the most important factors related to progression, and CMV viremia was the strongest predictor of death.

AIDS-Related Opportunistic Infections↗
PubMed2004

[Extrahepatic manifestations of hepatitis C virus infection].

Hepatitis C virus predominantly affects the liver, although it may also produce a number of extrahepatic manifestations, such as mixed cryoglobulinemia, salivary and lacrimal gland dysfunction, and several types of kidney disease. The pathogenesis of these conditions is not completely understood, but immunologic mechanisms are involved in many cases. In some patients with hepatitis C virus infection, the extrahepatic manifestations predominate and their proper diagnosis and management is very important.

Antiphospholipid Syndrome↗
PubMed2003

Hepatitis C virus and human immunodeficiency virus coinfection in Spain.

OBJECTIVE AND METHODS: In a cross-sectional study, based on a cohort composed of HIV-infected patients of fifteen tertiary level institutions of Spain, the main data of the entire cohort are described, characteristics of patients with or without hepatitis C coinfection are compared, and the possible association of hepatitis C virus coinfection with socioeconomic, HIV-related, and hepatitis B-related variables is assessed. RESULTS: A total of 4,709 patients are studied. Median of age is 37 years, 78.3% are male. HIV risk behaviours are: parenteral drug use in 63.8% of patients, heterosexual in 22.3%, and homosexual in 10.8%. Serology of hepatitis C is positive in 69.2% of participants. The following variables are associated with increased prevalence of hepatitis C coinfection, both in univariate and in multivariate analysis: HIV risk behaviour, positive anti-HBs, longer time elapsed since HIV infection diagnosis, younger age, lower social status, lower CD4 cell count increase between nadir and last available result, and lower educational level (all P<0.001). Patients with heterosexual behaviour are more frequently coinfected than patients with homosexual behaviour (P<0.001). CONCLUSION: This study highlights that, in Spain, more than two thirds of patients with HIV infection are coinfected with hepatitis C virus.

Adult↗