Biomedical subjects

C Gimeno Cardona

Publications and source records attributed to C Gimeno Cardona.

3 recordsLinked to original sources

PubMed1999

[An analysis of prior antibiotic treatment on the impact of meningococcal disease in children of the Valencian Community. The Study Group of Invasive Diseases].

OBJECTIVE: The objective of this study was to describe the effect of antibiotics given prior to hospitalization of children with meningococcal disease and to assess their relationship with disease outcome and microbiological isolation. PATIENTS AND METHODS: A prospective surveillance system in all hospitals of the Community of Valencia was implemented. All cases of children less than 15 years of age with clinically suspected invasive disease and: 1) N. meningitidis isolated in a normally sterile body fluid; 2) positive capsular antigens in blood or CSF and a positive Gram stain; and 3) clinical diagnosis of an invasive N. meningitidis disease. RESULTS: In a two-year period 157 cases were reported. In 143 cases, data about antibiotic prescription prior to hospitalization was known. Of these, 24.5% had received antibiotics and none had received parenteral penicillin or cephalosporins. Oral antibiotics decreased bacterial isolation (p < 0.001) and did not modify outcome (p = 0.66). CONCLUSIONS: Oral antibiotics, not recommended for N. meningitidis diseases, did not modify prognosis, but decreased bacterial isolation, and therefore worsened clinical handling of the cases and epidemiological studies.

Adolescent↗

PubMed1998

[Vaccination against Haemophilus influenzae type b in the Valencia Community: efficacy and failure of vaccinations].

OBJECTIVE: To study Haemophilus influenzae type b (Hib) conjugate vaccine effectivity and vaccine failures in the Valencian Community of Spain where vaccine can be obtained, but is not scheduled as a routine immunization. PATIENTS AND METHODS: A prospective surveillance system where pediatricians and microbiologists of all public hospitals of the Valencian Community reported cases of invasive Hib disease in children (under 15 years of age). Vaccination status (number of doses, dates and type of vaccine) in each case was obtained. RESULTS: Of 23 cases reported from December 1, 1995 to November 30, 1996, two had received at least one dose of Hib vaccine. One was a true vaccine failure and the other an apparent vaccine failure. Estimating a vaccine coverage of 32.5% of the children less than 5 years old, the direct vaccine effectivity was 90.6% (IC 95%: 27.9-98.8%). CONCLUSIONS: Hib conjugate vaccine is effective in the Valencian Community, however, there is still invasive disease due to the low vaccine coverage and some vaccine failures.

Child, Preschool↗

PubMed1997

[Inflammatory response in acute myocardial infarction. Predictive values].

INTRODUCTION AND OBJECTIVES: Our purpose was to investigate the significance of inflammatory acute phase response early after myocardial infarction. We also observed how these indices were influenced by trombolytic therapy. METHOD: We examined the blood samples of 200 non consecutive patients at the first day of acute myocardial infarction (155 [77%] males; mean age 65 +/- 13 years) to characterize the proteins and proinflamatory reactants profile. Results were correlated with hospital mortality. Thrombolytic therapy was administrated to 117 patients on admission and in these patients the samples were taken after the procedure. RESULTS: Overall mortality was 8%. Serum C-reactive protein (69 vs 41 mg/l), haptoglobine (237 vs 190 mg/dl), gammaglobuline (0.93 vs 0.84 g/dl), alpha-1-globuline (0.28 vs 0.23 g/dl) and alpha-2-globuline (0.7 vs 0.6 g/dl) were significantly higher in patients without trombolytic therapy. Conversely, patients who had received lytic therapy, had higher plasma concentrations of interleukin-1 beta (104 vs 40 pg/dl). The only clinical variable which was associated with mortality was a Killip class > or = 2 on admission (mortality = 21%; odds ratio = 5.2; p = 0.02). Other biochemical variables associated with a higher mortality were a white blood cell count > 10/nl (mortality = 12%; odds ratio = 5.4; p = 0.01), increased activated neutrophils > 80% (mortality = 18%; odds ratio = 5.4; p = 0.004) and C-reactive protein > 20 mg/l (mortality = 11%; odds ratio = 6; p = 0.05). Only patients with activated neutrophils > 80% on admission had a higher probability of dying during hospital stay (Exp[B] = 3.6; B = 1.2; r = 0.29; p = 0.001). CONCLUSION: The acute phase reaction in early myocardial infarction is determined by thrombolytic treatment. A high increase of activated neutrophils on patient admission is the only biochemical predictive value for hospital mortality.

Aged↗