Thrombophlebitis and Reiter's syndrome.
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Adult↗
Biomedical subjects
F Díaz
Publications and source records attributed to F Díaz.
[Pyogenic liver abscess. Study of 20 patients treated with percutaneous drainage].
We conducted a descriptive study of pyogenous hepatic abscesses (PHA) and their treatment with percutaneous drainage and antibiotherapy in the general hospital of Galdácano between 1989 and 1992. We assessed prevalence, clinical characteristics, responses to treatment, evolution and complications. We studied 20 PHAs in adults confirmed through puncture guided with echography and/or computerized tomography. We considered as causal germs those isolated in the abscess and/or hemocultures. All the patients were treated with catheter drainage and antibiotics. After discharge, follow-up and regular TC controls were performed at least for 6 months. The average age of the patients was 56 +/- 3 years and the men/women rate was 2.5:1. The most frequent origin of the infection was cholecystitis/cholangitis in 50% of patients and hydatidic cysts in 20%. Twelve patients had isolated abscess and 8 patients, multiple abscesses. The diagnostic sensitivity was 95% for the echography and 100% for CAT. The most frequent germs were E. Coli, Streptococcus, K. pneumoniae and Salmonella spp. In three cases, it was not possible to bacteriologically identified the germ. After drainage, the abscesses disappeared in 16 patients. The average duration of percutaneous drainage was 10 days. Three patients required surgery after drainage due to complications or incomplete drainage; two other patients required extirpation of hydatidic cysts. The mortality rate was 10%, although it was not related to PHA. We did not observe any differences between isolated or multiple abscesses with regard to prognosis. The drainage guided by echography and/or CT, associated to antibiotic therapy, is a successful technique for the treatment of PHAs in most patients.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Boix Ochoa's antireflux procedure returns patients to normalcy: 24 hour esophageal pH monitoring of 21 cases].
A great controversy exist concerning the surgical management of gastroesophageal reflux (GER). It is well known that Nissen procedure produces a hypercorrection of the gastroesophageal competency and often a "gas bloat syndrome". On the other hand, the Boix Ochoa's technique is more physiological but corrects GER allowing the persistence of a "radiological" reflux. The aim of the study was to demonstrate the accuracy of this procedure. 287 pediatric patients were studied because of GER and abnormal barium upper gastrointestinal series. 24 hours esophageal pH monitoring was performed in all this patients and in 21 the results were clearly pathological. They were operated on and six months later were new evaluated with upper GI series and continuous 24 hours esophageal pH monitoring. The results were compared with those previous to operation and also with a control group. Statistical great significance was found between presurgical and postsurgical data, what determine the efficacy of the procedure. No statistical significance was found between postsurgical data and the control group, what means that Boix Ochoa's procedure resolve GER without hipercorrection.
Gastroesophageal Reflux↗
[Surgical management of congenital tracheal stenosis].
A six month old infant with dextrocardia, butterfly vertebrae and oesophageal atresia type I is reported. After surgical repair, she developed respiratory distress, needing ventilatory support. The bronchoscopy and bronchography demonstrated segmental tracheal stenosis. A resection of the stenotic segment was performed, and tracheal reconstruction with terminoterminal anastomosis. After a period of clinical improvement, respiratory distress came back and reestenosis was ascertained locating its level on the anastomosis. Three sessions of balloon dilation were ineffective and because that it's decided the introduction of a metallic self-expandable stent. After a transient relief, the patient had a bilateral pneumonia ending with the dead of the patient. In spite of the treatment used, it was not possible to accomplish solution in a middle or a large place. This constitutes a clear exponent of the complexity in the management of the congenital tracheal stenosis.
Anastomosis, Surgical↗
Cyclospora species--a new protozoan pathogen of humans.
BACKGROUND: Organisms referred to as "cyanobacterium-like bodies" have now been identified worldwide in the feces of both immunocompetent and immunocompromised patients with diarrhea. Organisms with a similar appearance have been isolated from Peruvian patients since 1985. From 1988 to 1991 we studied prospectively two cohorts of infants and young children infected with this organism. We now attempt to identify it. METHODS: Fecal samples were collected weekly from the children and examined with the use of acid-fast staining and staining with a monoclonal antibody specific for cryptosporidium. Stools positive for cyanobacterium-like bodies were preserved in potassium dichromate and exposed to conditions allowing coccidian sporulation and excystation. Both unsporulated and sporulated oocysts were fixed by freeze-substitution techniques and then examined by electron microscopy. RESULTS: Organisms isolated from the feces of Peruvian patients and two patients from the United States were identified as belonging to the coccidian genus cyclospora, after sporulation and excystation of the oocysts according to standard techniques. Complete sporulation occurred within 5 to 13 days in oocysts maintained in potassium dichromate at 25 or 32 degrees C. Complete excystation resulted in the liberation of two sporozoites from the two sporocysts within each oocyst (cryptosporidia have four naked sporozoites within each oocyst). The presence of organelles characteristic of coccidian organisms was confirmed by electron microscopy. CONCLUSIONS: We have identified organisms of the genus cyclospora that are remarkably similar to cryptosporidia in their morphologic features and the diarrheal disease that they produce in humans. The complete life cycle and epidemiology of this new protozoan parasite remain to be described.
Aged↗
Bioimpedance monitoring of rehydration in cholera.
Measurement of bioimpedance (BI) is a simple non-invasive technique that relies on the different conductivity of tissues to define body composition and can be easily adapted to automated monitoring. We assessed the accuracy of BI in monitoring rehydration and acute fluid fluxes in 35 Peruvian cholera patients. Patients were monitored throughout the acute phase of diarrhoea and followed up at 3 and 10 days. BI was compared with other objective measures of dehydration including packed cell volume, serum protein, and calculated fluid balance. BI rapidly detected inadequate treatment and acute fluid flux, correlating highly with intravascular hydration as measured by serum protein and packed cell volume. BI values during dehydration were significantly raised compared with 10-day convalescent values and age-matched controls (p < 0.05). We also encountered an unexpected difference in the bioelectrical response to dehydration and rehydration between sexes. We conclude that BI has uses in monitoring dehydrated patients, in oral rehydration trials, and in physiological studies.
Acute Disease↗
Study of serum procollagen type III peptide in patients with hepatic cirrhosis from a clinical point of view.
N-terminal procollagen-III peptide (P-III-P) has been considered a marker of fibrogenesis and inflammatory activity of the liver. We measured the P-III-P serum levels in 83 cirrhotic patients fully characterized from a clinical and laboratory point of view. Cirrhotic patients had significantly higher P-III-P serum levels than controls (P < 0.0001). Of the cirrhotic patients 73.5% had increased P-III-P. A significant negative correlation was found between P-III-P and transaminases, and patients with normal values of alanine amino-transferase had higher P-III-P serum levels than those with increased values (P = 0.03). On the other hand, no significant association was found with portal hypertension, Child classes, or alcoholic liver disease. No one independent factor appears to be responsible for the increase in P-III-P. The measurement of serum P-III-P is of little if any use in the evaluation of cirrhotic patients.
Adult↗
Non-neuronal endogenous GABA efflux from the rat oviduct.
The subcellular distribution of Gamma-aminobutyric acid (GABA) was studied in the rat oviduct. The highest content of GABA was found in the soluble fraction. The effect of chemical stimulation of the endogenous GABA efflux from the rat oviduct was examined. High K+ concentrations could not induce elevation of the GABA efflux. Instead, a continuous spontaneous GABA efflux without change for long periods of time was observed. The total GABA content and GABA concentration were determined in the rat oviduct on days 1, 5, 10, 15, 30, 35 and 40 of the postnatal period and also during the estrous cycle. During postnatal development the GABA levels increase gradually with time reaching at prepuberal age a concentration similar to that found in diestrous rats. In the estrous cycle both GABA content and GABA concentration reached the highest value in the proestrous and the lowest value in the estrous phase. These findings support the hypothesis that GABA efflux may be modulated by the changes in oviductal fluid volume during the estrous cycle.
Analysis of Variance↗
Persistent lung infection due to Mycobacterium szulgai.
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Antitubercular Agents↗
Ablation of irreversibly rejected renal allograft by embolization with absolute ethanol: a new clinical application.
Surgical allograft nephrectomy has been the conventional therapy for removing failed kidney allografts when clinical manifestations of graft intolerance appear. However, removal of a transplanted kidney is an extensive surgical procedure. On the other hand, transcatheter vascular embolization (TVE) has proven useful in ablating organs and could be applied to renal transplant ablation. The aim of this study was to present the results of TVE for the treatment of graft intolerance syndrome (GIS) in failed allograft kidneys. Transcatheter vascular embolization was performed in 14 allograft recipients (33 +/- 13 years of age; 10 men and four women) affected by GIS after irreversible kidney allograft failure. Graft intolerance syndrome was diagnosed by fever (93%), hematuria (50%), graft pain (36%), flu-like symptoms (29%), and increased graft size (29%). Absolute ethanol (0.1 mL/kg body weight) was injected in the allograft artery, and in seven patients a stainless steel coil was left in the renal artery following ethanol injection. All patients showed clinical disappearance of the GIS. No major complication occurred, although a postembolization syndrome of pain, fever, hematuria, numbness, and paresthesia of the affected area appeared in 11 of the 14 patients. After 2 to 56 months of follow-up no late complications occurred, with the exception of a graft abscess formation in one patient after 6 months of embolization. Subsequent transplantectomy was uneventful. In conclusion, TVE is a safe and effective method for kidney graft ablation, and it may become an alternative treatment for GIS following irreversible rejection.
Adult↗
Study of the DNA content of basal and suprabasal keratinocytes in psoriatic patients.
We carried out a cytophotometric study of the DNA content of basal and suprabasal keratinocytes using involved and uninvolved histological sections of epidermis from psoriatic patients using the Feulgen technique. The reference 2C value of the DNA content was obtained from lymphocyte nuclei in a sub-epidermal infiltrate from normal skin. According to the DNA content profiles obtained for the keratinocytes of psoriatic patients, individuals were classified into three groups: Group 1, composed of individuals with a monomodal diploid profile and preferential keratinocytes with a 2C DNA content and, hence, a low proliferation activity; Group 2, consisting of patients with significantly increased 2C-4C and 4C populations; and Group 3, made up of individuals with high proportions of 4C and hyperdiploid (6C, 8C, and > 8C) keratinocytes. The results obtained in this work and the observed changes in the proliferative activity of the keratinocytes in the three groups of patients led us to suggest that the cytophotometric determination of the DNA content of basal and suprabasal keratinocytes may be useful as a prognostic criterion for the classification of psoriatic patients in terms of the extent of alteration of their proliferative epidermal activity.
Adult↗
Serum concentrations of laminin in cirrhosis of the liver.
Laminin, a glycoprotein synthesised by Ito cells, has been considered a marker of fibrogenesis. The behaviour of laminin and clinical and laboratory data in 83 patients with cirrhosis were studied to find the factors associated with increases in this glycoprotein. There were increased concentrations of laminin in 62.7% of the patients (40% of the Child's A, 64.5% of the Child's B, and 75% of the Child's C categories). Significant differences in laminin concentrations were found between the Child's grades (p = 0.009) and between patients and controls (p < 0.0001). Correlations were found between laminin concentrations and mean corpuscular volume, aspartate aminotransferase, aspartate aminotransferase: alanine aminotransferase ratio, alkaline phosphatase activity, bilirubin and glycocholic acid concentrations, and hypoalbuminaemia--that is, variables related to liver insufficiency and alcohol intake. Moreover, patients with an alcohol intake higher than 100 g/day had higher laminin concentrations than those with a lower intake (p = 0.03). Conversely, there was no significant association with portal hypertension. Multivariate analysis showed that mean corpuscular volume, bilirubin concentrations, and hypoalbuminaemia were independently associated with laminin concentrations. Poor degradation associated with liver insufficiency seems to play an important part in the increase in serum laminin concentrations in these patients.
Adult↗
Relationships between characteristics of exposure to pigeon antigens. Clinical manifestations and humoral immune response.
An extensive clinical study has been performed on pigeon breeders in the Canary Islands. Three hundred forty-three subjects have participated in this study through the filling of a clinical and epidemiologic questionnaire. A venous blood sample was also taken from each fancier for a further serologic analysis. Detection of specific IgG antibodies was made by an indirect enzyme-linked immunosorbent assay (ELISA) using pigeon serum as antigenic material. Twenty-nine (8 percent) breeders fulfilled the "classic" pigeon breeders' disease (PBD) criteria. One hundred six (31 percent) had rhinitis, 62 (19 percent) had immediate bronchial symptoms, and 51 (15 percent) suffered from chronic bronchitis. A significant level of specific IgG was detected in 139 (40 percent) cases. Rates were correlated with pneumonitis symptomatology (p < 0.001) and with chronic bronchitis (p < 0.05). There was a significant association between the number of pigeons and the level of sensitization (p < 0.001). Finally, a statistical relationship between the intensity of exposure and specific IgG response was also found (p < 0.001). Titers of specific IgE could not be related either to the reported symptomatology in the questionnaire or to any of the exposure parameters analyzed.
Adolescent↗
[Topical treatment of otorrhea].
A study has been carried out with 167 cases of discharging ears treated topically by means of lavages with a formic solution followed by the instillation of a quantity of boric drops. The material and methods used are exposed, together with the results achieved, taking into account that most the cases had been previously multi-treated with antibiotherapy, with adverse outcome. This procedure is cheap, effective and with scarce side-effects.
Animals↗
Subclavian catheter-related infection is a major risk factor for the late development of subclavian vein stenosis.
Although subclavian vein stenosis is a well-known complication of haemodialysis subclavian catheters, little is known about its causes. Catheter-related infection is the most common complication of this technique, but its role in the genesis of late subclavian stenosis has not been established. We retrospectively analysed 80 subclavian catheterizations in a total of 54 chronic haemodialysis patients from a single center. Sixteen catheters had to be removed because of a well documented catheter-related infection: three catheter-related sepsis (2 with ipsilateral phlebitis), seven isolated fever with catheter tip colonization which disappeared after catheter removal, and six exit-site discharge with positive culture. For comparison we matched 14 contemporaneous catheters which were electively removed without evidence of infection and with a negative culture of the catheter tip. A venogram of the ipsilateral arm was performed in all the cases after more than 6 months of catheter removal. Both groups were remarkably similar with respect to age, sex, side of insertion, number of inserted catheters, time of indwelling, and time elapsed from removal to venography. Definite subclavian stenosis was three times more common among patients with previous catheter-related infection (75% versus 28%; P < 0.01). Interestingly, both patients with ipsilateral phlebitis showed total occlusion of the subclavian vein. Although all diabetic patients of the study (n = 6) suffered a catheter-related infection, the incidence of late subclavian stenosis was not more common than in non-diabetic infected patients. In summary, subclavian haemodialysis catheter-related infection is a major risk factor for the development of late subclavian vein stenosis.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Lipid levels of a healthy population in the region of Extremadura].
We present the results of the first epidemiological study on lipidic levels among a healthy population from Extremadura. The study included 1.128 subjects, 520 males and 608 females, distributed by age and sex. Average total cholesterol levels were 228 +/- 40 mg/dl among middle-age and 215.6 +/- 43 mg/dl among women. We observed a significant reduction of these figures in ages above 60. In addition, we observed significant differences in HDL-Ch levels between men and women from all ages, with higher values among women and we only observed significant differences regarding total cholesterol levels between men and women in the 20-29 and 40-49 age-groups. Total cholesterol levels were higher than 220 mg/dl in more than half the studied population between 40 and 60 years of age and higher than 250 mg/dl in 20% of the subjects in such age groups. These data suggest the need for dietary changes in near 70% of the population if cholesterol levels are to approach the recommendations of the Sociedad Española de Arteriosclerosis.
Adolescent↗
[Endoscopy and echography in a case of Schönlein-Henoch purpura with gastroduodenal involvement].
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Duodenal Diseases↗
Compensatory growth in broiler chicks fed on Lemna gibba.
The growth of broiler chickens on diets containing various levels of Lemna gibba was evaluated. Groups of broiler chicks were fed on diets containing 0-400 g Lemna gibba/kg for 3 weeks. These chickens were then changed to standard diets for a further 2 weeks. As the level of Lemna gibba increased, feed consumption and weight gain decreased. However, when diets were changed to the standard diet, compensatory growth was observed. In a second experiment, diets were formulated with a metabolizable energy of 5.02 MJ (1200 kcal)/kg Lemna gibba and included a finer-milled Lemna gibba. Chickens were fed on diets containing 0-300 g Lemna gibba/kg for 4 weeks. Each group was then divided into two subgroups. For the next 2 weeks one of these sub-groups was maintained on the experimental (Lemna gibba) diets (LL), while the other sub-group was changed to a standard diet (LS). Bird fed at levels above 150 g Lemna gibba/kg had decreased consumption and weight gain. These birds when changed to a standard diet tended to have increased weight gain compared with chickens continuously fed standard rations. LS birds had significantly higher weight gains and feed consumption and lower feed conversion than LL birds. In contrast to older birds, chicks fed on Lemna gibba at high concentrations showed growth retardation. When changed back to a standard diet they demonstrated normal or compensatory growth.
Animal Feed↗