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F Segura

Publications and source records attributed to F Segura.

At least 19 recordsLinked to original sources
PubMed2006

Seroepidemiological study of Rickettsia felis, Rickettsia typhi, and Rickettsia conorii infection among the population of southern Spain.

Rickettsia typhi and Rickettsia conorii, the etiologic agents of, respectively, murine typhus and Mediterranean spotted fever, are recognized as frequent causes of fever of intermediate duration in southern Spain; in addition, in recent years Rickettsia felis has been detected in potential vectors in this area. Nevertheless, limited data exist regarding the actual prevalence of past infection due to these three pathogens. In the present study, the prevalence of past infection due to R. felis, R. typhi, and R. conorii was determined in a representative population of southern Spain during 2002. In addition, the possible risk factors associated with exposure to these pathogens were investigated. An epidemiological survey was completed by all subjects included in the study. Serum samples were tested by indirect immunofluorescence assay. The prevalence of past infection due to R. felis, R. typhi, and R. conorii among the 504 total subjects was 6.5, 3.8 and 8.7%, respectively. In multivariate analysis, infection due to R. felis was independently associated with a high-risk occupation (one that required working outdoors in nature, close contact with domestic animals, or potential contact with rodents) (OR=5.8; 95%CI 2.1-15.6), while infection due to R. typhi was associated with older age (factor of 1.04 [95%CI 1.008-1.068]) and frequent insect bites (OR=10.3; 95%CI 2.3-45.5). Two factors were associated with infection due to R. conorii: a high-risk occupation (OR=9.3; 95%CI 3.7-23.2), and participation in outdoor activities (OR=7.2; 95%CI 1.4-38.5). The results confirm the widespread prevalence of past infection due to R. felis, R. typhi, and R. conorii in the population of southern Spain.

Adolescent↗
PubMed2006

Prevalence of Rickettsia slovaca in Dermacentor marginatus ticks removed from wild boar (Sus scrofa) in northeastern Spain.

Rickettsia slovaca, the causative agent of TIBOLA, is transmitted by Dermacentor ticks. Dermacentor marginatus is the most widely species distributed in northeastern Spain, and the wild boar constitutes the main host. D. marginatus ticks were collected from hunter-killed wild boar and were tested by PCR/RFLP. Rickettsial DNA-positive ticks were sequenced using the ompA PCR primers. The prevalence of R. slovaca in D. marginatus ticks was 17.7%. Other spotted fever group rickettsiae were detected in ticks, but these were not definitely identified.

Animals↗
PubMed2006

[Helicobacter pylori does not contribute to iron deficiency in hemodialysis patients].

BACKGROUND: Many studies in the general population have shown a link between Helicobacter pylori infection and iron-deficiency, often resulting in iron-deficient anaemia. Despite the high prevalence of iron deficiency in hemodialysis patients, no studies have been performed in this population. OBJECTIVE: To evaluate the role of Helicobacter pylori infection in the appearance of anemia and the iron requirements in our hemodialysis population. MATERIAL AND METHODS: After excluding patients with severe pathology and short life expectancy and those with blood losses secondary to other causes, 79 patients were included.Iron requirements and anaemia were determined by iron serum, ferritin, and hematocrit values; and by transfusion, eritropoietin and iron requirements. The diagnosis of Helicobacter pylori status was established by the concordance of at least two of the three non invasive diagnostic methods performed (breath test, serology and fecal antigen of Helicobacter pylori). RESULTS: Prevalence of Helicobacter pylori infection was 43%. No significant differences between patients infected or not by Helicobacter pylori were found in any of the variables analysed: hematocrit (33.5% versus 34.1%), serum iron (58.9 versus 63.7 pg/dl), ferritin(340.3 versus 264.2 ng/ml), transferrin saturation index (22.5% versus 25.2%), dose of eritropoietin administered (96.6 versus 93.5 U/kg/weekly), and parenteral iron (1,389 versus 1,538 mg/year). A noteworthy finding was that patients with Helicobacter pylori infection had been on hemodialysis for a shorter period than those without (37.4 versus 63.7 months,p = 0.04). CONCLUSION: Helicobacter pylori infection has no effect on anaemia (hematocrit, Eritropoietin dose or iron needs) in our hemodialysis patients. Prevalence of Helicobacter pylori is lower in patients with longer time on dialysis. We consider that the diagnosis of Helicobacter pylori infection must be reserved for clinical peptic ulcer suspicion or patients on transplant waiting list.

Aged↗
PubMed2005

Presence of human past infections due to the Bar29 rickettsial strain in Southern Spain.

The prevalence of past infections due to Bar29 rickettsial strain in a population from Southern Europe, as well as the possible risk factors associated to exposure to this rickettsia, were analysed. Among the 504 subjects included, global prevalence of past infections was 3.4%. Past infections were significantly more frequent in rural areas compared to urban (10.8 vs. 3.2%, OR 3.6 [1.1-12.3], P = .05), and suburban areas (10.8 vs. 1.9%, OR 6.2 [1.3-28.9], P = .02). In multivariate analysis the factors that were independently associated to past infection due to Bar29 strain were higher age (P = .037; factor of 1.033 [1.002-1.066]), and a risk profession (P = .005; OR = 5.7 [1.6-19.6]). These data point towards the presence of past Bar29 strain infections in a population from Southern Spain.

Adolescent↗
PubMed2004

Diagnosis of Helicobacter pylori infection in dyspeptic patients by stool antigen detection usefulness of a new monoclonal enzyme immunoassay test.

BACKGROUND: Helicobacter pylori antigens can be measured in human stools with an enzyme immunoassay, which may prove to be a valuable non-invasive diagnostic tool. Aim. To evaluate the usefulness of a new monoclonal enzyme immunoassay for detecting H. pylori antigens in dyspeptic patients' faeces (FemtoLab H. pylori, Connex, Martinsried, Germany). PATIENTS: H. pylori infection was determined in 75 patients (49 men, 26 women, mean age 52 + 16.5) for histology and rapid urease test. METHODS: H. pylori status was established by concordance of the reference tests. FemtoLab H. pylori was measured in triplicate. In addition, two determinations of a polyclonal faecal antigen test (HpSA, Platinum Premier HpSA, Meridian Diagnostic Inc., Cincinnati, USA) were also performed. Sensitivity, specificity, positive and negative predictive values were calculated. Concordance between different measurements was estimated by Kappa statistics. RESULTS: The sensitivity of the FemtoLab H. pylori immunoassay ranged from 98 to 100% and its specificity was 76%. Positive and negative predictive values were 91 and 94-100%, respectively. Concordance coefficients ranged from 0.81 to 0.92. Corresponding HpSA values were 69, 86, 92 and 53%, respectively. Concordance coefficient was 0.61. CONCLUSIONS: FemtoLab H. pylori is a very sensitive, specific, highly reproducible and easy-to-perform tool for diagnosis of H. pylori infection.

Adolescent↗
PubMed2003

Q fever in adults: review of 66 clinical cases.

Sixty-six cases of Q fever in adults, serologically confirmed by indirect immunofluorescence, were studied to analyze the epidemiological, clinical and therapeutic aspects of the disease. Eighty-three percent of the patients were male, and the mean age was 44.7 years. Contact with animals was recorded in 24 patients. The main clinical form of presentation was pneumonia (37 cases); eight patients had hypoxia, and five had respiratory failure. The empirical treatment consisted of macrolides in 36% of cases. Evolution was favorable in all cases.

Adult↗
PubMed2003

[Evaluation of a rapid test (ImmunoCard STAT! HpSA) for Helicobacter pylori detection in stools].

INTRODUCTION: The use of a rapid diagnostic technique may be extremely useful for the management of Helicobacter pylori infection. A new immunochromatographic in-office test (ImmunoCard STAT! HpSA, Meridian Diagnosis Inc, Cincinnati, Ohio, USA) for the detection of H. pylori in feces has recently become available. The aim of the present study was to evaluate the diagnostic reliability and reproducibility of the ImmunoCard STAT! HpSA test in patients with dyspepsia. PATIENTS AND METHODS: Sixty-three dyspeptic patients were enrolled. H. pylori status was determined by CLO-test and Giemsa staining of antral biopsy. Patients with a positive result for both tests were considered infected and those with a negative result for both tests were considered not infected. Fecal H. pylori antigen was tested twice by ImmunoCard STAT! HpSA. The sensitivity, specificity, positive predictive value and negative predictive value of each determination were calculated. The concordance between the two determinations was evaluated using Kappa statistics. RESULTS: Of the 63 patients, 46 were infected by H. pylori. Sensitivity, specificity and positive and negative predictive values were 89-91%, 86-93%, 96-98% and 72-75%, respectively. The correlation coefficient between determinations was 0.845. CONCLUSION: The new ImmunoCard STAT! HpSA test shows good sensitivity and reproducibility. Therefore, it could be highly useful in the management of H. pylori infection.

Adolescent↗
PubMed2002

Primary HIV type-1 infection misdiagnosed as Mediterranean spotted fever.

The case studies of four patients, two men and two women between the ages of 42 and 54 years, are described. They presented to a hospital emergency department during the summer months with acute fever and exanthema. These are the primary symptoms of Mediterranean spotted fever (MSF), an endemic rickettsial disease in the Mediterranean basin that is seen particularly during the summer. The patients were clinically diagnosed as having MSF, but their diagnoses were not confirmed by serological testing. One patient was diagnosed with primary human immunodeficiency virus type 1 infection (HIV-1) 10 days later. The remaining three patients were diagnosed with HIV infection years later, but it is very likely that they also had primary HIV infection when MSF was presumed. When a patient develops sudden onset of fever and a maculopapular rash that is characteristic of MSF, the possibility of primary HIV-1 infection should be considered.

Adult↗
PubMed2002

Epidemiology of invasive Streptococcus pneumoniae infections in children in an area of Barcelona, Spain.

AIM: Streptococcus pneumoniae is the most common cause of bacteraemia, pneumonia, sinusitis and acute otitis media. With the advent of conjugate vaccines, there is now the possibility of preventing disease caused by this organism. However, little is known about the epidemiology of invasive pneumococcal disease in children in Spain. The aim of this study was to determine the incidence and the clinical and microbiologic characteristics of invasive pneumococcal disease in Sabadell, an industrial area in the province of Barcelona, Spain. METHODS: From January 1990 to December 2000, the case records of children with pneumococcal invasive disease at Sabadell Hospital were retrospectively (1990-1996) reviewed and prospectively (1997-2000) collected. The hospital serves a population of 61,143 children under 15 y of age, 18,073 children under 4 y of age and 7300 children under 2 y of age. RESULTS: A total of 112 children (54% under 24 mo of age and 93% under 6 y of age) with invasive pneumococcal disease were diagnosed during a period of 11 y. The incidence of invasive pneumococcal disease was 76 per 100,000 for children aged 0 to 24 mo, 45 for children aged 0-48 mo and 16.6 for children aged 0-14 y. Occult bacteraemia was the most common manifestation of invasive pneumococcal disease (66 cases), pneumonia was the second form (34 cases) and meningitis (10 cases) and arthritis (2 cases) were the other clinical manifestations. Of the 105 strains tested, 8.6% were highly penicillin resistant, 37.1% were intermediately penicillin resistant. 16.2% were intermediately cefotaxime resistant and 32.4% were erythromycin resistant. Pneumococci of serogroups 6, 14, 18, 19, 1, 5, 4, 9, 23 and 33 were the most frequently isolated groups (92%) but only 6, 9, 14, 19 and 23 were resistant to penicillin, cefotaxime, or erythromycin. CONCLUSIONS: In this study the incidence of invasive pneumococcal disease was found to be greater than that reported elsewhere in Spain and Europe. Penicillin resistance levels are high but the trend towards increasing penicillin resistance may have ended over the past few years. The currently licensed seven-valent (7-V) pneumococcal conjugate vaccine would cover 78% of cases of invasive pneumococcal in children aged 0-14 y, 80% in children aged 0-24 mo and 100% of cases of penicillin- or cefotaxime-resistant invasive pneumococcal disease.

Bacteremia↗
PubMed2001

[Protein-calorie malnutrition and lymphocytopenia as predictors of hospital infection in the elderly].

BACKGROUND: Clinical and epidemiological studies have established that malnutritionis a risk factor for infection in patients being submitted to surgery. To date no study has been carried out to establish the association between the nutritional condition and the incidence of hospital-acquired infections in patients in the medical area. We study the incidence of hospital-acquired infections in the elderly in an attempt to determine the rate of this infection and its association with protein-calorie malnutrition. Another aim of this study has been to determine the predictive value of the parameters used to evaluate the patient's state of nutrition and immunity. PATIENTS AND METHOD: We included 240 patients over 64 years old, 118 males and 122 females, admitted to the medical area of a general hospital. The nutritional and immunity condition of the patients was evaluated through determinations of weight, height, body mass index, hypoalbuminemia and total lymphocyte count. The psichophisical degree of dependence was evaluated through of Norton scale. The details on the hospital infections came from a clinical and microbiological follow-up of patients, in accordance with the criteria of the Centers for Disease Control of Atlanta. RESULTS: The frequency of protein-calorie malnutrition was 12.5% and the accumulated incidence of hospital-acquired infections was 19.6%. Functional incapacity of the elderly prior to hospitalization (odds ratio,4.70; 95% CI: 1.1-19.0) as well as the presence of certain extrinsicrisk factors (odds ratio, 2.35; 95% CI: 1.1-5.1) were, in addition to hypoalbuminemia (odds ratio, 3.60; 95% CI: 1.3-10.2) and lymphocytopenia(odds ratio, 2.67; 95% CI: 1.3-5.7), the independent variables that showed the most significant association with the incidence of hospital-acquired infections. CONCLUSIONS: The nutritional parameters associated with the immune system determinedgreater risk of hospital-acquired infections among elderly patients admitted to the medical area of a hospital. The initial evaluation of elderly patients hospitalitzed in accordance whit the psychophysical degree of dependence based on the Norton scale is useful to evaluate those patients who were at greater risk for hospital infections.

Aged↗
PubMed2001

Eleven-year study of recurrent pneumococcal bacteremia.

In order to describe the epidemiology and the clinical and microbiological manifestations of recurrent pneumococcal bacteremia, a long-term study was conducted. Between January 1988 and December 1998, a total of 344 episodes of bacteremia caused by pneumococci was detected in 331 patients. Thirteen (3.9%) of these patients experienced recurrent episodes of pneumococcal bacteremia, and all of them had underlying diseases. In 12 of these patients the recurrence was considered to be a reinfection, and in one patient it was considered to be a relapse. Three patients were found to harbor identical strains in both bacteremic episodes, as determined by pulsed-field techniques. Only hematological neoplasia appeared to be a predisposing factor for recurrent pneumococcal bacteremia.

Adult↗