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I Dorronsoro

Publications and source records attributed to I Dorronsoro.

29 records · Page 2Linked to original sources
PubMedDate not supplied

[Epidemiological surveillance of HIV/Aids infections in Navarra between 1985 and 2002].

In the year 1985, the first cases of Aids were diagnosed in Navarra. Since then and until December 2002, according to the notifications received, 2,329 persons with HIV have been counted, of whom 1,538 were from Navarra and 791 temporary residents in this autonomous community. In recent years, the incidence of new diagnoses of HIV infection and cases of Aids has shown a clear tendency to fall in Navarra. The decrease in cases has been very important amongst the users of intravenous drugs, while the cases amongst homo/bisexuals and cases related to heterosexual transmission have remained fairly stable. In the 1999-2002 period, the cases of infection through a sexual relationship have been more numerous than the cases registered in users of intravenous drugs. The proportion of cases in persons originating from countries with a high endemicity is increasing, coming to represent about 25% of the new cases of infection in the 2000-2002 period. The follow up of the 1,538 HIV patients of Navarra has shown that, at the end of 2002, death had occurred in 39.5% of cases, and it was possible to confirm that 55% were still alive. With regard to their relation to the health services, it has been found that of the 847 patients who are still living, the great majority (80%) are being attended to by the Infectious Services of the Hospital of Navarre and another 9.4% in the Internal Medicine Services of the Garcia Orcoyen and Reina Sofia Hospitals.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Outbreak of multiresistant tuberculosis].

BASIS: Six cases of multiresistant tuberculosis diagnosed in the Hospital of Navarra in 1996 were studied. MATERIAL AND METHODS: Sensitivity tests were carried out using the BACTEC 460TB system against four main anti-tuberculosis medicines: Isoniazid, Streptomycin, Rifampizin and Ethambutol. "Fingerprinting" techniques by means of RFLP with IS 6110 were used in the epidemiological study. RESULTS: Four of the patients were also infected with HIV. All of them had a fatal short-term prognosis. These four showed resistance to the drugs under study; in three resistance was primary, and secondary in the fourth. The molecular study showed that three HIV+ patients had identical patterns of restriction fragment length polymorphism (RFLP). Two were brothers and nosocomial infection was demonstrated in the third. On the other hand, the RPLF pattern of these patients showed great similarity to that of one of the HIV- patients, which suggests a clone origin of the strains, no other epidemiological relationship being found. The RPLF pattern of the other HIV+ patient was identical to that of another of his strains, isolated 14 months before, with the first strain sensitive. The other two patients were HIV- women, and they evolved favourably. In one, who was diabetic, a multiresistant tuberculosis had been diagnosed 7 years before, remaining asymptomatic up until the present. The other involved a secondary resistance due to deficient treatment. CONCLUSIONS: The appearance of multiresistant tuberculosis is a very serious problem amongst HIV+ patients, especially at a time when their life expectancy has improved considerably due to the new therapies. In HIV- patients, multiresistant tuberculosis has a better prognosis. Typification by means of restriction fragment length polymorphism is very useful in clarifying the origin of the cases.

English Abstract↗
PubMedDate not supplied

[Epidemiological surveillance of HIV/AIDS in Navarra].

More than fifteen years have passed since the first cases of AIDS were diagnosed in Navarra in 1985. According to the notifications received from then until December 2001, 2,400 people have been counted with HIV infection, of whom approximately 700 have developed AIDS, and 565 have died of AIDS or other causes. The incidence of new infections by HIV, cases of AIDS and deaths related to the latter, have shown a clear tendency to decline in Navarra in recent years. The decrease in cases is very important amongst the users of intravenous drugs, while the cases amongst masculine homo/bisexuals and amongst persons infected following a heterosexual encounter have remained fairly stable. For the first time, starting in 1999, persons infected through a sexual encounter are higher than the users of parenteral drugs. There has been an increase in the proportion of cases of AIDS and infection in persons originating from countries where the disease is endemic, accounting for over 23% of new cases of infection in the years 2000 and 2001. The figures for Navarra also reflect the important reduction of cases of AIDS and AIDS-related deaths since the introduction of more efficient anti-retroviral treatments in 1996. The strategies for the detection of HIV infection in persons who have maintained risk practices is important if we consider that in the years 2000 and 2001, there was a simultaneous diagnosis of infection and disease in one in every five patients. This implies that these persons did not benefit from treatments in the same way as they would have if the diagnosis had been made earlier.

English Abstract↗
PubMedDate not supplied

[Progress in the control of HIV infection and AIDS in Navarre, 1985-2003].

The epidemiological situation of HIV infection and AIDS in Navarre in 2003 is reviewed. Up until December 2003, 1,610 HIV infections had been diagnosed in residents of Navarre, of whom 41% had died. The new diagnoses of HIV fell by some 81% between 1993 and 2003, a year in which 28 cases were diagnosed (4.8 per 100,000 inhabitants). The fall basically occurred in infections in injection drug users, since the cases due to sexual transmission had remained stable. Over half of the infections diagnosed in the period 2000-2003 (58%) were attributable to heterosexual transmission, 18% occurred in parenteral drug users and 12% in homosexual men. Thirty-three percent were persons originally from other countries. The incidence of AIDS fell from 75 cases in 1996 to 20 in 2003, and mortality from 65 to 8 cases, respectively. In the 2000-2003 period, the average annual incidence of AIDS was 4.2 per 100,000 inhabitants and the average annual rate of mortality was 1.6 per 100,000 inhabitants. At the end of 2003, there were 902 living persons with a diagnosis of HIV monitored by the health system (1.6 known infections per 1,000 inhabitants). In 2003, 65% of the youths aged between 15 and 29 referred to coital sexual relations, a higher percentage than in previous years, but their level of information on the prevention of AIDS was acceptable. It is necessary to insist on prevention and to adapt this to the new situation.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

[Study of the resistance of Mycobacterium tuberculosis to the principal tuberculostatics (Hospital of Navarra 1996-2003)].

INTRODUCTION: The aim of this study was to evaluate the sensitivity to the principal tuberculostatics of the M. tuberculosis stocks isolated in our laboratory and to study the factors related to resistance. METHODS: Study of 475 stocks of M. tuberculosis corresponding to all cases diagnosed in the eight year period between 1996 and 2003. We employed the BACTEC 460TB system, together with Lowenstein solid medium, in the cultivation of the samples. The sensitivity studies were carried out using the BACTEC 460TB system. RESULTS AND CONCLUSIONS: Both the incidence and the number of cases of resistant tuberculosis showed oscillations over the eight years of the study. The fact that there is no homogeneous tendency makes it necessary to maintain active surveillance of this process. Global resistance to isoniacide was 8%, making it is convenient to carry out sensitivity studies in all the diagnosed cases. The cases of multiresistant tuberculosis (resistant to at least isoniacide and rifampicin), did not exceed 3%. The prognosis of the patients with resistant tuberculosis was bleak in cases of coinfection with HIV; however, when the immunological defences were conserved, and guidelines for treatment with active drugs were provided, the recovery of the majority of the patients was achieved. At present, sensitive and rapid procedures are available to us, making it recommendable to study the sensitivity of all the stocks of M. tuberculosis that are isolated; this is essential in the case of HIV positive or immigrant patients.

Antitubercular Agents↗
PubMedDate not supplied

[Evolution of the epidemiological characteristics of tuberculosis in Navarra (1994-2003)].

AIM: To describe the changes in the incidence and the epidemiological profile of tuberculosis in Navarra. METHODS: The cases of tuberculosis in the 1994-2003 period were analysed. Cases reported to the system of obligatory notifiable diseases, completed with the microbiological diagnoses and the cases collected in other health registers. RESULTS: The incidence of tuberculosis fell from 21 per 100,000 inhabitants in the five-year period 1994-1998 to 16 per 100,000 in 1999-2003. In both periods the number of cases in men doubled that in women, and the maximum incidence occurred in the age groups from 25 to 44 and over 65 years of age. The diagnoses of tuberculosis in persons with HIV infection fell from 15.1% to 6.6% and those in immigrants rose from 2.2% to 21.3%. Somewhat over 3% of the cases had received prior anti-tuberculosis treatment and about 6% showed resistance to some medicine, without significant differences between periods. The proportion of potentially transmissible tuberculosis (73%) underwent no significant changes, nor did that of those with positive sputum bacilloscopy. The number of outbreaks (groupings of two or more cases) rose from 18 to 26 and the percentage of cases secondary to another recent case rose from 3.6% to 10.1% (p<0,001). In the 1999-2003 period, pulmonary localisation occurred in isolated form in 67.7% of the patients, and in combination with other localisations in another 5.1%. The isolated pleural form appeared in 9.9% and the meningeal form in 1.5%. CONCLUSION: There has been an advance in the control of tuberculosis although its incidence is still high with respect to other European countries. Control of imported cases is one of the challenges to be faced in coming years, without neglecting control measures in the autochthonous population.

Adolescent↗
PubMedDate not supplied

[Evaluation of the MTD-2 test for the direct detection of Mycobacterium tuberculosis in specimens].

BACKGROUND: To evaluate the utility of the Amplified Mycobacterium Tuberculosis Direct Test (MTD-2, Gen-Probe) in the microbiological diagnosis of tuberculosis. METHODS: We evaluated the results obtained in 146 specimens with the MTD-2 test, together with those of the culture and smears. The MTD-2 test was performed on all the smear positives specimens (n=47), on the smear-negative specimens, when the test was demanded (n=19), and in other smear-negative specimens previously selected, according to the clinical history of the patient (n=80). We considered real cases of tuberculosis, those that were culture positive for Mycobacterium tuberculosis and those that were specifically treated. RESULTS: The overall sensitivity, specificity, positive and negative predictive values for the MTD test were: 95, 76, 71, and 96%, for the culture; and 84, 100, 100 and 90% and 75, 94, 89 and 86% for the smears, respectively. In smear positive specimens, the test showed a great specificity, and differentiated M. tuberculosis from other mycobacteria. In the smear negatives, the sensitivity of the test was low and so was the positive predictive value, especially in series performed with a high work load. CONCLUSIONS: Data from our study show that the MTD-2 test is a reliable method for rapid diagnosis of tuberculosis in smear positive specimens. However, due to its low sensitivity and positive predictive value, it is not recommended in the routine diagnosis of tuberculosis. Also, for this reason, whenever a positive result is obtained with a smear negative specimen, the result needs to be confirmed with another specimen.

Bacteriological Techniques↗
PubMedDate not supplied

[Disseminated Mycobacterium africanum infection].

A case of disseminated Mycobacterium africanum infection in a 28 years old black male with no known causes of immunosuppression and resident in Spain 2 years prior to his symptomatology is described. In addition, the characteristics of Mycobacterium africanum and its capacity to produce pathology in man are discussed as is its proper treatment leading to satisfactory cure.

Adult↗