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F Segura

Publications and source records attributed to F Segura.

At least 55 records · Page 3Linked to original sources

[Acute gastroenteritis: a prospective study of 445 cases].

Four hundred and fourty-five adult patients suffering acute gastroenteritis (AG) seen at the emergency ward of two hospitals in Barcelona, have been studied. The aim of this work was to analyze the cause of AG in our community and to evaluate the utility of the biologic and clinical criteria chosen as indicators of bacteremia or of AG produced by invasive microorganisms. Stool culture was positive in 157 patients (35%) of which 140 were Salmonella sp. The most frequently isolated serotype was S. enteritidis. Eight patients (7.8%) presented Salmonella sp. bacteremia. Presence of an underlying disease, dehydration, shivers, fever, presence of occult blood in stools, septic hemogram and the history of AG in other family members were more common in patients with a positive stool culture (p less than 0.05). Patients with bacteremia presented dehydration with a significantly higher frequency than nonbacteremics. The rest of the parameters studied were similar in both groups. We conclude that Salmonella sp. is the most frequently encountered microorganisms responsible for adult AG in our community. It is possible to identify patients with AG due to Salmonella sp. based on clinical and biological parameters. On the contrary, it is necessary to perform a wider study in order to determine the parameters that may allow the identification of patients with bacteremia.

Acute Disease↗

[Acute enteritis caused by Salmonella: effect of mecillinam and cotrimoxazole on the clinical course and fecal carrier state].

In a prospective randomized study we have evaluated the influence of co-trimoxazole and mecillinam on the clinical outcome and the fecal Salmonella sp carrier status in 134 adult patients with acute non-typhi Salmonella sp enteritis. The patients were distributed in three groups on the basis of predefined clinical and biological criteria, depending on their risk of bacteremia or severe complications of it, or on the enteroinvasive character of the causative organism. The inclusion in any group determined the treatment. Seventy-six patients received mecillinam (1.200 mg/day p.o.), 36 co-trimoxazole (1.600 mg/day p.o.), both during five days, and 22 only diet. The patients were investigated after 1, 3 and 6 weeks until stool culture was negative. The isolated Salmonella strains, either in stool or blood culture, had a sensitivity of 98.3% to mecillinam and 96.9% to cotrimoxazole. Resistance did not develop during therapy. All patients had a favorable outcome, including the six with bacteremia. No differences were found regarding clinical features (diarrhea, abdominal pain, fever) or the rate of positive stool cultures in the three therapeutic groups in any of the follow-up controls. It was concluded that the administration of mecillinam or co-trimoxazole to patients with Salmonella sp enteritis is not associated with a prolongation of the state of fecal carrier or with the development of resistant strains.

Adult↗

Diagnostic value of tumoral markers in serous effusions: carcinoembryonic antigen, alpha1-acidglycoprotein, alpha-fetoprotein, phosphohexose isomerase, and beta 2-microglobulin.

In order to discriminate between benign and malignant effusions, the value of carcinoembryonic antigen (CEA), alpha 1-acidglycoprotein (AGP), alpha-fetoprotein (AFP), phosphohexose isomerase (PHI), and beta 2-microglobulin (B2M) has been estimated in serous effusions in a group of 106 patients, 30 with a malignant and 76 with a benign effusion. Mean CEA and AGP levels in malignant effusions were significantly higher than in benign effusions; no significant differences of mean PHI, AFP and B2M levels of benign and malignant effusions were found. CEA level estimations were useful for confirming malignancy in 27% of malignant effusions but in only 7.5% of all effusions, and AGP and PHI for excluding it in 37.5 and 36.0% of all effusions, respectively. With the combination of CEA with AGP or PHI, a correct diagnosis was achieved in only 45 and 44% of all effusions, respectively. The combination of AFP or B2M with CEA, AGP or PHI did not improve the discriminative value for differentiating malignant and benign effusions.

Ascites↗