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Biomedical subjects

F Asensi

Publications and source records attributed to F Asensi.

At least 19 recordsLinked to original sources
PubMed1999

[Comparison between penicillin and amoxicillin-clavulanic acid for the treatment of recurrent tonsillopharyngitis in childhood].

Fifty-one children aged 2-14 years with recurrent tonsillopharyngitis, presenting dysphagia, fever and lymphadenitis, with more than two similar episodes in the last three years and showing a beta-hemolytic group A streptococci in the pharyngeal smear, were studied. They underwent random treatment for ten days with phenoxymethylpenicillin (40-60 mg/kg/day) (n = 28) or amoxicillin-clavulanic acid (20-40 mg/kg/day) (n = 23) taken orally three times a day. Clinical and bacteriological tests were carried out at 10 days and 2, 6 and 12 months post-treatment. The clinical and bacteriological results showed the superiority of the amoxicillin-clavulanic acid treatment both in the short term (disappearance of symptoms) and in the long term (decrease in recurrence). These results support the idea that betalactamases produced by the pharyngeal flora play an important role in the failures of penicillin.

Adolescent↗
PubMed1998

[Human immunodeficiency virus and resistance].

It has been demonstrated that following prolonged treatment with reverse transcriptase inhibitors, especially with nucleoside analogs, resistant viral strains appear that show mutations in the nucleotides of the gene that codifies reverse transcriptase. These mutations cause changes in amino acids, which gradually increases resistance. In this study we evaluated the applicability af the LiPA HIV-1 RT test in determining the presence of mutations in this gene that can lead to resistance to antiretroviral treatments.Twenty-one samples were studied without previous knowledge of the antiviral treatments that the patients had received. No mutations in the HIV-1 stains from untreated patients were found. In the other patients who had undergone various treatment regimens, the results obtained With the LiPA HIV-1 RT made in possible to retrospectively identify the different nucleoside analogs they had been treated with. The most frequently found mutations were those that lead to a certain degree of resistance to AZT, followed by those related to resistance to ddl, which in effect in this order were the drugs used in the treatment of the patients. However, the LiPA HIV-1 RT test has certain limitations. It can only detect mutations that can be recognized by its sequences. As such, including sequences that would make it possible to study the possible genotypic variations in the gene that codifies the protease of HIV-1 would be helpful, given the importance of the protease inhibitors in clinical practice. In any case, direct sequencing continues to be standard method as it allows us to obtain full information on the genes that need to be studied.

Anti-HIV Agents↗
PubMed1997

[Acute epiglottitis caused by Haemophilus influenzae type b in children: presentation of 21 cases].

BACKGROUND: The aim of this paper is to review the epidemiological, clinical and therapeutical characteristics of Haemophilus influenzae type b (Hib) epiglottitis in children at a time when an efficient and safe vaccination is available. METHODS: The clinical histories of 21 children admitted to Children's Hospital La Fe (1971-1996) with a clinical diagnosis of epiglottitis and isolation of the microorganism in blood cultures (20 cases) and surface culture of the epiglotis (one case) are reviewed. RESULTS: The annual average was 4/100,000 children under 5 years of age. Evolution prior to diagnosis was > 12 hours in 52.4% of the cases. More males were affected (52.4% vs 47.6%). All the children except one (95.2%) were under 5 years of age; 81% were under 3 years of age and 1 child was 6 years and 8 months old. Respiratory distress (100%) and fever > or = 38 degrees C (85.7%) were the most common clinical manifestations. General health was affected in 71.4% of the cases and 66.7% had leucocytosis on admission. The clinical diagnosis was confirmed by direct visualization of the epiglotis in 76.1% of the cases. Hib was isolated in blood culture in 20 cases (95.2%). The strains produced beta-lactamases and were ampicillin-resistant in 57.1%. 19 children (90.5%) required endotracheal intubation. Initial empiric antibiotic therapy was third generation cephalosporins (cefotaxime or ceftriaxone) alone or combined with ampicillin. One child died (4.8%). CONCLUSIONS: Pediatricians must still be aware of this serious infection in order to diagnosis and treat it as early as possible.

Acute Disease↗
PubMed1995

Economic aspects of a general vaccination against invasive disease caused by Haemophilus influenzae type b (Hib) via the experience of the Children's Hospital La Fe, Valencia, Spain.

With the aim of studying whether a general vaccination against invasive disease caused by Haemophilus influenzae type b (Hib) is economically profitable bearing in mind the efficacy and safety of the vaccine, its price and the global cost that this disease has in our area, a review is conducted of patients admitted due to invasive disease caused by Hib in the Children's Hospital La Fe, Valencia, born between 1984 and 1993. They total 100, 63 who have meningitis. In the 81 cases (56 with meningitis) born between 1984 and 1990 (years that can be regarded as "closed" since all the patients were younger than 5 years of age) the total cost has been calculated for hospitalization, care during the acute phase, care for the sequelae (6 severe and 7 mild) and death (5 cases). The mean annual cost of care can be calculated at 62 million pesetas, without making an economic valuation of the loss of life, and at 205 million pesetas taking this factor into account. The annual cost of vaccinating the 7000 babies under one year of age and falling within the Hospital's catchment area, on the basis of a vaccination pattern of three doses (at 2, 4 and 6 months) or four doses (at 2, 4, 6 and 15 months) would amount to 63 or 84 million pesetas, normal price to public (not covered by National Health Service), and 40 or 51 million pesetas if acquired by National Health Service. As a conclusion we can state that, even from the economic point of view, without quantifying the cost of the loss of life, a public general anti-Hib vaccination would be profitable in our area since it would mean an administration cost lower than that of the care required by patients. This is without taking into account the fact that emotional, family and social serious disturbances would also be avoided due to hospitalization, sequelae and deaths caused by a disease which is today perfectly preventable.

Bacterial Capsules↗
PubMed1993

Risk/benefit in the treatment of children with imipenem-cilastatin for meningitis caused by penicillin-resistant pneumococcus.

A new case of pneumococcal meningitis in a child successfully treated with imipenem-cilastatin after failure of standard antibiotics is presented. Seizures, as the major adverse effect, were easily treated and no sequelae were later observed. The difficulty in distinguishing between seizures due to meningitis and those due to imipenem is discussed. We conclude that imipenem-cilastatin is a good alternative therapy in children's meningitis caused by pneumococcus resistant to standard antibiotics.

Anti-Bacterial Agents↗
PubMed1991

[Epidemiological study of the clinical forms of tuberculosis at the La Fe Children's Hospital of Valencia (1986-1989)].

We analyze, in a retrospective review, the clinical presentation of tuberculosis among 226 pediatric patients admitted to the Hospital Infantil La Fe of Valencia (Spain) during the years 1986-1989. We observed the persistence of severe forms of tuberculosis, such as miliary tuberculosis and tuberculous meningitis. Also, cases of extra-pulmonary tuberculosis seldom encountered nowadays like bone and joint, intestinal and lymph node infection were recorded. In view of the current status of pediatric tuberculosis, new recommendations should be developed, because this infection could potentially be eradicated if adequate treatment and prophylactic guidelines are followed.

Adolescent↗
PubMed1983

[Pharmacologic evaluation of penicillin in children with meningococcal meningitis].

Levels of penicillin both in blood and CSF are determined in 11 children with meningococcal meningitis. Authors compare these values with MIC. The therapeutic pattern was 500.000 Ul/Kg/day of benzylpenicillin, in six doses, with a single initial doses of 200.000 Ul/Kg. The results recommend not to use a lower doses in order to assure a permanently efficient penicillin concentration.

Cerebrospinal Fluid Proteins↗
PubMed1981

Pericentric inversions of chromosome 12 in two families.

Two cases of pericentric inversion of chromosome 12 are presented, one 46,XX,inv(12)(p13;q11) and the other was also a heterozygotic carrier of the inversion. These inversions were detected among 4035 cytogenetic analyses carried out in patients with psychosomatic retardation and/or malformations (357 with a Down phenotype) and in patients with histories of miscarriages, sterility, or growth failure. In cases studied from a review of the literature together with our own we found that among 3235 cases of Down syndrome there were 7 patients with trisomy 21 and inherited balanced reciprocal translocation involving chromosomes other than pair 21. The frequent participation of some chromosomes in these balanced reciprocal translocations, above all those of group A (1-3), suggests that these and probably other rearrangements could make the segregation of chromosome 21 easier.

Child↗