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Biomedical subjects

C Muñoz

Publications and source records attributed to C Muñoz.

216 records · Page 12Linked to original sources
PubMedDate not supplied

[Late hepatitis C virus seroconversion in a patient on hemodialysis].

We present a case of an exceptionally late HCV seroconversion in a hemodialysis patient. The clinical case illustrates the difficulty of appropriately and quickly isolating a HCV infected patient, and it demonstrates the necessity to consider all the dialysis patients as potentially infectious patients. The standard precautions in hemodialysis must be applied routinely to all the patients, because the diagnosis of the HCV infection is very often late, and on some occasions it is difficult to interpret correctly the results of the available diagnostic tests.

Adult↗
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[Hematoma of the anterior rectus abdominis muscle as the first manifestation of lymphoproliferative disease after renal transplantation].

Rectus sheath hematoma results from the rupture of rectus muscle vessels by trauma, coagulation disorders or anticoagulant therapy, but it can occur spontaneously too. Its prognosis is good. On the other hand, posttransplant lymphoproliferative disorders (PTLD) are serious and potentially fatal complications in transplant recipients. Patients with PTLD have a mononucleosis-like syndrome or develop extranodal masses which involve various organs. We report the case of a renal transplant recipient who develop a rectus sheath hematoma as the first clinical feature of PTLD.

Hematoma↗
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[Balance nutrition in the diabetic patient].

Nutrition is an integral part of the monitoring and care of diabetes. Compliance with a nutritional plan is, however, one of the most difficult goals to achieve due to the changes in lifestyle that it implies. In order to integrate nutrition effectively into the follow-up and control of diabetic patients, it is necessary to have a multidisciplinary team of professionals basically comprising a doctor specializing in Endocrinology and Nutrition, a dietician and a trainer in diabetes issues. These team members have to apply an individualized approach for each patient and provide nutritional education to enable patients to be self-sufficient. Test results (blood-glucose levels, HbA1c, lipids, blood pressure and quality of life) must be regularly assessed and, if the desired goals are not achieved, the necessary changes must be indicated for future monitoring and overall management of the condition.

Alcoholic Beverages↗
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[Myasthenia gravis associated with carcinoma of the thymus. A report of three cases].

INTRODUCTION: Although the association between benign neoplasias of the thymus and myasthenia gravis is well known, with greater predominance of squamous thymomas over other histological types, carcinoma of the thymus is only exceptionally associated with auto immune disorders. CASE REPORTS: We present three patients with myasthenia gravis associated with carcinoma of the thymus. They were three men aged between 38 and 73 years. Clinical features of myasthenia were generalized in two cases and ocular only in the third. Antireceptor antibodies to acetylcholine and anti striped muscle antibodies were present in all three patients. Repetitive stimulation was abnormal in two of the three cases. On CAT of the thorax there was a tumour of the thymus with the radiological characteristics of a benign thymoma in two of the patients and data suggesting an invasive thymoma in the third. In all three cases the diagnosis of carcinoma of the thymus was made on the post operative histological findings. CONCLUSIONS: The association of carcinoma of the thymus with myasthenia gravis in our series of cases was probably due to chance. We consider that this association is exceptional since the histological characteristics of carcinoma of the thymus do not favour the development of auto immunity.

Adult↗
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[Nosocomial transmission of the hepatitis C virus in hemodialysis: monitors, personnel, or both?].

BACKGROUND: The Hepatitis C virus (HCV) infection is the most frequent cause of hepatic disease in the dialysis population. Many observations suggest that nosocomial transmission is the principal way of infection. OBJECTIVE: The aim of this study was to investigate HCV outbreak in a hemodialysis (HD) unit, using epidemiological and molecular methods. METHODS: 50 patients in a HD unit were tested for HCV-RNA by reverse transcription-polymerase chain reaction (PCR), and the hepatitis C genotype determination (reverse hybridization assay). We analyzed the distribution of different genotypes by shifts and dialysis machines and the temporal association in the appearance of the HCV cases. RESULTS: 21 of 50 patients (42%) showed detectable anti-HCV antibodies (HCV-Ab) in serum. The prevalence of HCV RNA positivity was 90.4% (19/21) among these patients. None of the HCV-Ab negative patients detectable HCV virus in thein blood. The PCR genotyping of HCV RNA was performed in 19 patients. It detected the presence of HCV subtype 1b in 10 out of 19 viremic patients (52.6%), HCV-subtype I a in 31.5% of the patients (6/19) and genotype 3 in 15.7% (3/19) of the viremic patients. All patients had been infected by only one genotype. We found epidemiological correlation and temporal association between the genotypes 1b (p < 0.05) and 3 (p < 0.05) with the shifts. The HCV genotype 1a shows statistical association with the machine 1 (p < 0.05) but not temporal association. CONCLUSIONS: HCV genotype 1b was dominant in our cohort of HCV-infected patients. There was a high level of agreement between the PCR detection of HCV RNA and the detection of antibodies against the HCV genome. Genotyping and epidemiological analysis suggest that horizontal nosocomial patient to patient transmission plays an important role in the epidemiology of HCV in dialysis patients. There is a need for stringent implementation and regular auditi of infection control measures.

Cross Infection↗
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[Nutritional effect of bariatric surgery with Scopinaro operation. Analysis of 40 cases].

OBJECTIVES: To analyze the influence of bariatric surgery over nutritional status in patients with morbid obesity after 1 year of following. To know the influence of specific factors as age, sex and common channel's length. DESIGN: Retrospective study from 1998-2001. SUBJECT: All patients suffering from morbid obesity that had been operated during this period of time, 40 subjects: 28 women and 12 men with a mean age of 38 +/- 12 years old. Were studied. METHODS: We analyzed the variations of weight and other anthropometric measures, biochemical parameters and the micronutrient (vitamins A, D, E, B12, folate, C, zinc, Calcium, Magnesium) status during 1 year of following after surgery. RESULTS: Percentage weight loss was 29.7 +/- 2.9% without sex differences. A significant (p < 0.005) descent of serum cholesterol, triglycerides, and uric acid level as well as liver function markers was observed. All the hyperglycemic disturbances were reverted. 97% and 48% of the patients developed hypovitaminosis A and D respectively, that was correlated to steatorrhea. Vitamin E deficiency was found in 72% of the patients, and zinc deficiency in 68% CONCLUSIONS: Our expected weight loss 1 year after bariatric surgery is 30%, irrespective of sex and age. This loss is accompanied by a significant improvement in metabolic parameters, but the high prevalence of micronutrients deficiency that was found makes an early supplementation and close follow-in of these patients very advisable.

Adult↗
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[Current prevalence of trichinosis in Santiago, Chile (1992). A study on 500 corpses].

In August-December 1992, 500 diaphragm muscle samples taken at random from people who were autopsied at the Santiago Medico-Legal Service, were submitted to phototrichinoscopy to search for encysted larvae of Trichinella spiralis. For each sample seven small pieces were examined. Three hundred and eighty nine (77.8%) cadavers corresponded to males and one hundred and eleven (22.2%) to females. Ages ranged from 1 to 90 years. Ten (2.0%) of the individuals examined resulted positive, the higher frequencies corresponding to individuals over 20 years of age. The prevalence rate of T. spiralis infection found is rather similar to those detected in 1966-1967, 1972 and 1982, with percentages of 2.2, 3.4 and 2.8 respectively.

Adolescent↗
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[Performance of carriers and non-carriers of the E280A mutation for familial Alzheimer's disease in a naming test].

INTRODUCTION: Early preclinical diagnosis is the greatest challenge faced by researchers into dementia. Cognitive, neuroanatomical, neurophysiological and genetic markers have been reported. One of the preclinical cognitive markers is anomia and it is often assessed using visual naming tests. AIMS: The aim of this study was to analyse the type of mistakes made in a visual naming test in a group of carriers and non-carriers of the E280A PS1 mutation. PATIENTS AND METHODS: The sample was made up of 91 participants who were genotyped for the E280A PS1 mutation and divided into three groups: non-carriers (n = 30), asymptomatic carriers (n = 39) and sick carriers (n = 22). Selection was performed using the Minimental and the Fast and EDG scales and mistakes in the CERAD naming test were classified. The types of mistakes taken into account were: no answer, visual, semantic, phonological, the whole for the part, and not related. RESULTS: There is a significant difference in the number of semantic errors between non-carriers and asymptomatic carriers; on comparing the three groups, no statistically significant differences were found in visual mistakes. CONCLUSIONS: Visual mistakes are a general characteristic, even in healthy subjects and, therefore, these errors did not provide any information that could be used to classify patients with or without dementia. Semantic mistakes can be considered as being a preclinical sign in familial Alzheimer's disease (FAD). Both visual and auditory naming tests must be applied when evaluating patients with FAD.

Adult↗
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[Current status of clinical nutrition at the network of public hospitals from Castilla y León].

INTRODUCTION: Clinical nutrition is an activity realized in most of Health Centres of France, Canada, Great Britain and USA. The aim of our work was to determine activity and resources of Nutrition Units of Hospitals in the Community of Castilla y León. MATERIAL AND METHODS: A questionnaire was send to all Hospitals of Castilla y León (SACYL); Hospital Universitario Rio Hortega, Hospital Clinico Universitario, Hospital Comarcal de Medina del Campo, Hospital General Yagüe-Divino Vallés (Burgos), Complejo Hospitalario de Le6n, Hospital General de Segovia, Hospital Virgen de Sonsoles de Avila, Hospital Virgen de la Concha de Zamora, Hospital Comarcal de Aranda de Duero, Hospital Comarcal de Miranda, Hospital General de Soria, Hospital Clinico Universitario de Salamanca. RESULTS: Nine Centres responded questionnaire (75%). A total of 5 Hospitals had a Unit of Nutrition (55.6%). The results showed an average of 0.37 +/- 0.55 specialists for each 400 beds, 0.87 +/- 0.63 nurses for each 400 beds and 1.91 +/- 2.3 auxiliaries for each 400 beds, with an average of 0.21 +/- 0.41 specialists for each 100,000 habitants, 0.49 +/- 0.36 nurses for each 100,000 habitants and 1.09 +/- 1.2 auxiliaries for each 100,000 habitants. The activity of these Units is demanded by other Units, with an average of 3.2 +/- 3.4 consultations per day. The main diseases of this activity were 33.3% tumoral pathology, 55.6% surgery and 11.1% neurological pathology. Oral supplements were the first intervention tool. Only 3 Centres had a home artificial nutrition consultation. The main diseases of this activity were post surgical patients (33,3%), tumoral pathology (33,3%), neurological pathology (22%) and inflammatory bowel disease (11%). CONCLUSION: Resources in Units of Nutrition of Castilla y Leon were limited. However, activity in Hospital an in home is equal than other areas. New actions of Local Administration are necessaries to follow recommendations of Council of Europe.

Hospital Units↗
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[Relation of prolactin with nodular hyperplasia and carcinoma of the prostate].

The relationship between prolactin in NH and prostate carcinoma has several aspects: under normal conditions, prolactin enhances androgens output, increasing the Leydig cell susceptibility to LH. At the prostate level, it increases testosterone binding to the prostate epithelium and stimulates the conversion of testosterone to dihydrotestosterone. On its own, it decreases prostatic protein degradation and increases the DNA synthesis index. With regard to Nodular Hyperplasia, once its hormone dependency is rated, it also appears to be stimulated by high levels of prolactin. The NH cell cultures with human prostate increase their growth, cell division, as well as the DNA synthesis. The aspects of the prolactin-prostate carcinoma interaction involve considering this hormone as a possible carcinogenic agent, emphasizing the existence of high plasma levels of this hormone in individuals with prostate carcinoma, where any androgen excess is considered a major factor at the genesis of this tumour, and prolactin increases indirectly its testicular synthesis. Also, prolactin itself stimulates the growth and development of carcinomatous human cell lines, increasing its effect in the presence of testosterone. For this reason, controlling this hormone levels becomes an element to have into consideration in the treatment and follow-up of these patients; also, the reevaluation of any drug therapy that, besides the initial goal pursued, does not maintain baseline prolactin levels. The association of anti-prolactin drugs has to be understood as a co-adjuvant therapy when there is androgenic deprivation, never as a single treatment.

Animals↗
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[Intestinal protozoan parasitism in children from the bay of Cádiz].

The prevalence of intestinal parasitosis from protozoa in a pediatric population group attending different education centres in the Bay of Cádiz is investigated by means of directly examining the feces using microscopic techniques. The percentage of children affected by parasites is 6.3%, there being no differences with regard to sex or social level. Giardia lamblia is the most frequently found protozoa (2.7%). The level of infection from Cryptosporidium sp. (2.3%) is significant. The symptomatology of those affected was nonspecific and not intense, and therefore did not lead to any suspicion of pathology.

Child↗
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Anapsos, an antipsoriatic drug, in atopic dermatitis.

An open, controlled study was carried out in young patients with atopic dermatitis, who during one month received oral anti-psoriatic drug, anapsos (n = 46), or antihistamines (n = 30), simultaneously with topic applications. The activity and extension of the cutaneous lesions improved under both treatments, but more markedly with anapsos in spite of the fact that topical applications did not contain steroids in the group treated with anapsos, and the effect was still appreciable several months after interruption of medication. Anapsos, which was well tolerated, considerably relieved the respiratory symptoms of all patients with asthma. Studies performed on patients with atopic dermatitis have shown high IgE levels, eosinophils and T4 counts, and a marked decrease in T8 suppressor cells in peripheral blood. Our data also show a slight decrease in T8 cells (%), a significant increase in T4 sub-sets (%) and a high T4/T8 ratio as a previously reported by several authors. Such an imbalance between helper and suppresor cells may cause alterations in the response to extrinsic and intrinsic antigens, as shown in particular by the abnormally high IgE levels observed in atopic dermatitis. Anapsos was associated with a correction in T lymphocytes imbalances, specifically through the increase of the initially low T8 cells levels and subsequent normalization of the mean T4/T8 index. The tolerance and promising therapeutic activity of this antipsoriatic drug deserve further research in other conditions characterized by a deficit of suppressor cells.

Administration, Oral↗
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[Ultrastructural study of the basal cells of the prostatic gland].

The ultrastructure of basal cell in canine and bovine prostate is studied. In the canine prostate only one type of basal cell could be specified, however in the bovine prostate type I and type II basal cells could be described. Canine basal cell and bovine type I have similar characteristic and never reach the alveolar lumen whereas bovine type II basal cell is columnar in shape, has numberous mitochondria in the apical pole and ocassionally reaches the alveolar lumen. Type II is a clearly defined intermediate cell between type I and secretory elements. All types of basal cells in both species have ultrastructural features which correspond to those of undifferentiated stem cells.

Animals↗
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[Etiology of enteritis in a university general hospital in Barcelona (1992-1995)].

BACKGROUND: The aim of the study was to describe the etiology of enteropathogenic agents over a four-year period (1992-1995) in a University Hospital in Barcelona. METHODS: We studied 12,793 stool samples, 4519 were obtained from patients under 15 years and 8274 were obtained from patients over 14 years. The specimens were examined for bacteriological, parasitological and virological enteropathogens. RESULTS: In 3380 specimens of 12,793 stool samples studied were identified an enteropathogen (26.4%). Polymicrobial associations were observed in the 6.8% of the cases. Pathogens were identified in 45% of children samples and 16.3% of adults samples. The etiological enteritis agents more frequently detected in the paediatric patients were Campylobacter (13.5%), rotavirus (11.3%) and Salmonella (10.2%); and Salmonella (4.9%), Campylobacter (3.1%) and Giardia intestinalis (2.1%) in adults. Cryptosporidium (13.5%) was the most frequent cause of gastrointestinal tract infections in HIV-infected subjects. In the children with stools positives, the presence of red and white blood cells were more frequent than the adults with stools positives (73% versus 26.6%). CONCLUSIONS: The enteropathogenic agents such as Campylobacter, Salmonella, and Giardia were the most frequent cause of gastroenteritis in our environment. In the children, rotavirus infections predominated during the cold months. The most frequent cause of gastroenteritis in HIV-infected patients was Cryptosporidium followed by Campylobacter.

Adolescent↗
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Unusual invasive bronchial aspergillosis in a patient with acute lymphoblastic leukemia.

Invasive tracheobronchial aspergillosis is an uncommon form of Aspergillus lung infection observed in immunocompromised patients. A 43-year-old patient diagnosed with acute lymphoblastic leukemia presented prolonged fever and hemoptysis during remission induction chemotherapy. The bronchoscopic examination showed pale mucosa with multiple raised white-colored nodules of 3 to 5 millimeters in diameter in all the bronchi. Hyphae of Aspergillus sp were observed in the biopsy of one of the nodules and in the examination of the bronchoalveolar lavage. Despite amphotericin B therapy, the patient developed bilateral necrotizing pneumonia and multiple abscesses in the brain and in the thyroid gland, and died. From a review of the literature in the Medline database, four similar cases (two in AIDS patients, one in lymphoma and the remaining case in an acute myeloid leukemia patient) have been reported.

Adult↗