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Biomedical subjects

F Parras

Publications and source records attributed to F Parras.

At least 37 records · Page 2Linked to original sources
PubMed1991

Enhanced attenuation of meningeal inflammation and brain edema by concomitant administration of anti-CD18 monoclonal antibodies and dexamethasone in experimental Haemophilus meningitis.

Antiinflammatory therapy has been shown to reduce the adverse pathophysiological consequences that occur in bacterial meningitis and to improve outcome from disease. In the present study, modulation of two principal steps of the meningeal inflammatory cascade was accomplished by concomitant administration of dexamethasone to diminish overproduction of cytokines in response to a bacterial stimulus and of a monoclonal antibody directed against adhesion-promoting receptors on leukocytes to inhibit recruitment of white blood cells into the subarachnoid space. Dexamethasone and antibody therapy produced a marked attenuation of all indices of meningeal inflammation and reduction of brain water accumulation after H. influenzae-induced meningitis in rabbits compared with results of each agent given alone and of untreated animals. In addition, the enhanced host's meningeal inflammatory reaction that follows antibiotic-induced bacterial lysis was profoundly ameliorated when dual therapy was administered without affecting clearance rates of bacteria from cerebrospinal fluid and vascular compartments. The combination of both therapeutic approaches may offer a promising mode of treatment to improve further the outcome from bacterial meningitis.

Animals↗
PubMed1991

[Epidemic outbreak of methicillin-resistant Staphylococcus aureus in a general hospital. Preliminary report].

The incidence of MRSA infections in Spain had remained in a low level through the years, being MRSA usually less than 1.5% of all S. aureus isolates. Since October 1988, we have detected in our hospital a MRSA outbreak. The epidemic started in the surgical wards, and spread through the rest of the institution. The incidence of cases was higher in the ICU's, areas that act as "multipliers" of the outbreak. In spite of standard control measures, the total number of patients with MRSA was 245 in April 1990. We studied prospectively a sample of 100 MRSA patients: thirty-six percent were colonized and 46% infected. The more common source of infection was the lower respiratory tract and primary bacteremia. The infection-related mortality was 30%. Our MRSA strain belong to phage type III, and shows a characteristic multiple antibiotic resistant pattern, the MRSA strain is sensitive to vancomycin, fusidic acid, phosphomycin and cotrimoxazole. Over the entire outbreak period, the MRSA strain developed resistance to rifampin, imipenem-cilastatin and ciprofloxacin. In spite of all control measures implemented, the outbreak can not have been totally controlled, and MRSA is now an endemic pathogen in our institution. Therefore, major changes in therapeutic approach to nosocomial infections have been since then introduced.

Adult↗
PubMed1990

[Mucormycosis. The disease spectrum in 13 patients].

Mucormycosis is an uncommon infection caused by fungi of the order Mucorales. During an 8-year period, mucormycosis was diagnosed in 13 patients from three Madrid hospitals. There were 8 males and 5 females, with ages ranging from 21 to 75 years (mean 45 years). There were several underlying diseases, and 4 patients had more than one. Five had diabetes mellitus, 4 chronic renal failure, 2 acute myeloblastic leukemia, 2 were narcotic abusers and were infected by the human immunodeficiency virus (HIV), 1 had non-Hodgkin's lymphoma, 1 was a carrier of a renal allograft and 1 had systemic necrotizing vasculitis. There were different clinical presentations: rhino-orbital in 3, paranasal in 2, cutaneous in 2, pulmonary in 2, primary cerebral in 2, rhinocerebral in 1, and peritoneal in 1. The diagnosis was made during the first week in 6 patients, in the second week in 4, and it was delayed for more than one month in 2. Fresh examination of clinical samples was carried out in 3 patients and hyphae were visualized in all 3. Cultures were taken in 10 patients and they were positive in 7. All isolates were identified as Rhizopus sp. One patient died within 24 hours without being treated, 12 were treated with amphotericin B and 9 received surgical therapy. Six patients (46%) died. The involvement of central nervous system and the absence of surgical therapy were associated with a poor outcome. These results indicate that mucormycosis can develop in several clinical contexts and has a varying clinical presentation. It is a potentially curable infections when early diagnosed and appropriately treated.

Adult↗
PubMed1990

Infectious endocarditis in children.

With the object of analyzing current characteristics of infectious endocarditis (IE) in children, we carried out a retrospective study of 23 cases of IE in children under 15 years of age seen at the Hospital Ramón y Cajal in Madrid (Spain) between 1977 and 1985. The incidence was high (1.3 cases per 1000 children admitted). The male/female ratio was 2:1. Eight patients were under 2 years of age and 15 over 2 years, the majority being adolescents. The two groups presented marked etiological and prognostic differences. Congenital heart disease was the predisposing factor in 20 of the 23 cases. Streptococcus viridans (nine cases) and Staphylococcus aureus (eight cases) were the most frequent organisms. Fourteen cases were on a native valve and nine were secondary (seven of these on prosthetic patches). In spite of advances in therapy, IE continues to be a severe illness: the mortality rate in our series was 26%. Factors associated with a poor prognosis were: age less than 2 years, Staphylococcus aureus as the causative agent, and the presence of prosthetic material.

Adolescent↗
PubMed1990

Serological diagnosis of neurobrucellosis.

The presence of antibodies was determined in the serum and cerebrospinal fluid in six patients with neurobrucellosis using the Rose Bengal test, the microdilution agglutination test, and the Coombs' test. Four of the patients were followed up for more than three months. The Rose Bengal test and the microagglutination test were positive in cerebrospinal fluid in five of the six cases at some stage. The Coombs' test was positive in cerebrospinal fluid in every patient and in one was the only positive serological test. Cerebrospinal fluid positivity is not excluded by low titres or negative results of antibodies in the serum for any of the three methods. A Coombs' test or some equivalent must always be made on the cerebrospinal fluid to diagnose neurobrucellosis.

Adolescent↗
PubMed1990

[Analysis of the sensitivity of mesophilic Aeromonas isolated from feces to antibiotics of everyday use].

The sensitivity to antibiotics of 56 mesophilic strains of Aeromonas (20 A. caviae, 18 A. sobria and 18 A. hydrophila) isolated from the feces of patients with enteritis, 89.2% of strains had some type of resistance, such as 83.9% to ampicillin, 32.1% to carbenicillin, 28.8% to cefalotin, 5.3% to co-trimoxazole and 1.7% to chloramphenicol. 48.2% of strains were simultaneously resistant to two of the tested antibiotics, 3.5% to three and 5.3% to four. 95.7% of ampicillin resistant strains were beta-lactamase producing. A. sobria was more sensitive to cefalotin (MIC less than 8 micrograms/ml) than the remaining species. This finding supports the use of that marker for identification.

Acute Disease↗
PubMed1989

[Infection caused by the human immunodeficiency virus, hepatitis B virus and delta virus in homosexual males].

Serological markers of hepatitis B (HBV) and human immunodeficiency (HVI) viruses were investigated in the sera of 90 homosexual males. In addition, in HBsAg positive individuals antibodies against delta virus (DV) were also investigated. Forty sera (44.4%) were positive for HBV and HIV, 61 (67.7%) for HBV and 52 (57.7%) for HIV. HBsAg was detected in 8 cases (8.8%), 7 of which had positive anti-HIV sera. In no case infection by DV was detected. These data show the high prevalence of HBV and HIV infection in the study population. They also suggest that the HBsAg carrier status is more common among HIV positive homosexual males and that the investigated homosexual population has not yet been infected by DV.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Chronic fatigue syndrome associated with Epstein-Barr virus infection].

Epstein-Barr virus (EBV) infection is ubiquitous and may result in multiple and widely different clinical features; the most common of these is infectious mononucleosis (IM). Recently, a group of patients has been included in the chronic EBV infection syndrome (EBVIS), with a sustained nonspecific syndrome consisting of asthenia, anorexia, low grade fever and changes in mood, associated with a viral infection not necessarily caused by EBV; this has been called chronic fatigue syndrome (CFS). We report a patient who fulfilled the criteria for CFS associated with EBV after an acute, well documented EBV infection. We discuss its etiological and pathophysiological implications, emphasizing the need for extreme caution in the diagnosis of CFS. A merely clinical diagnosis may hide severe mistakes.

Adult↗
PubMed1989

[Human infections caused by Enterobacter sakazakii. Microbiologic considerations].

The clinical and microbiological features of four patients with positive cultures for Enterobacter sakazaii are reported. They corresponded to two wound exudates, one appendicitis and one newborn conjunctivitis. The biochemical and physiological characteristics of this organism are analyzed (inability to ferment d-sorbitol and production of a non-diffusible yellow pigment); its difficult identification and the clinical rarity of its isolation are discussed. The relevant literature is reviewed.

Adult↗
PubMed1989

[Evaluation of the treatment with oral ciprofloxacin: experience with 24 patients].

We have evaluated the clinical effectiveness and possible side effects of oral ciprofloxacin therapy in 24 patients (11 females and 13 males). Two episodes from overall 25 infections were excluded of clinical and microbiological evaluation but were assessed regarding possible side effects. In most patients, the clinical condition was stable at the beginning of therapy. Only 3 patients had nonfatal diseases. Seventeen episodes were urinary tract infections (four of them with concomitant bacteremia), four chronic osteomyelitis, and two severe soft tissue infections; 21 episodes were monomicrobial, and two polymicrobial. The isolated organisms were mostly aerobic gram negative bacilli or facultative anaerobes: E. coli (9), Pseudomonas aeruginosa (5), Proteus mirabilis (5), Serratia marcescens (1), Klebsiella pneumoniae (1), Pseudomonas stutzeri (1), and Acinetobacter calcoaceticus (1). There were only two gram positive isolates: Staphylococcus aureus (1) and Staphylococcus epidermidis (1). The overall clinical response rate was 91%. Gastrointestinal tolerance was excellent. Colonization by Candida or Enterococcus developed in 3 cases (13%), and only one of them developed superinfection. Four patients developed several nervous system abnormalities, two increased transaminase activity and one drug exanthema. Ciprofloxacin appears as an effective drug for the monotherapy of several bacterial infections, including severe enterobacteriaceae and Pseudomonas infections.

Administration, Oral↗
PubMed1989

[Opportunistic infections of the central nervous system in patients with AIDS].

Between August 1985 and March 1989 we had evaluated 70 AIDS patients. We had identified 7 opportunistic Central Nervous System infections, others toxoplasmosis and tuberculosis: A case of progressive multifocal leukoencephalopathy presented with aphasia as their initial manifestation, a probable herpesvirus type 1 polyradiculoneuropathy, four cryptococcal meningitis and syphilitic neuroretinitis.

Acquired Immunodeficiency Syndrome↗
PubMed1988

Shigella sonnei bacteremia in an elderly diabetic patient.

A case of Shigella sonnei bacteremia in a 65-year-old patient suffering from diabetes mellitus is discussed. The isolated strain had plasmid-mediated serum resistance and excreted aerobactin. The presence of diabetes mellitus as an underlying disease and the production by the Shigella sonnei isolate of factors related to bacterial invasion may have contributed to the bacteremic episode.

Aged↗
PubMed1988

Blistering distal dactylitis in an adult.

Streptococci are responsible for a diverse spectrum of cutaneous infections like erysipelas, impetigo, and cellulitis. Blistering distal dactylitis is an infrequent, superficial infection of the anterior fat pad of the distal portion of the finger described classically in children. We report a case of blistering distal dactylitis in an adult caused by group A beta-hemolytic streptococci that was cured with oral phenoxymethyl penicillin. Familiarity with blistering distal dactylitis should permit the dermatologist and internist to diagnose this new entity in adults.

Adult↗