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Biomedical subjects

J Barberán

Publications and source records attributed to J Barberán.

At least 19 recordsLinked to original sources
PubMed2006

Management of infections of osteoarticular prosthesis.

Prosthetic joint infections are an uncommon complication of joint replacement surgery, but are associated with significant morbidity and costs when they do occur. Gram-positive cocci, in particular Staphylococcus aureus and Staphylococcus epidermidis, are the most commonly recovered microorganisms (>or=50% of all isolates). About 60% of prosthetic joint infections probably occur by direct contamination during the operative procedure. Certain systemic conditions in the patients, as well as foreign material, have been identified as risk factors for prosthetic joint infection. The clinical diagnosis is only certain when there are sinus tracts that reach the prosthesis or purulent secretion is obtained from joint aspiration or during open surgery. The treatment of an infected joint prosthesis must be individualised, but it generally involves both systemic antibiotics and surgical intervention. Exchange arthroplasty in one or two stages continues to be the standard approach to management. Prosthesis retention, in conjunction with debridement and prolonged (for at least 3 months) oral antibiotic therapy, can be an alternative for early postoperative or late acute haematogenous infections, when the duration of symptoms is less than 1 month, the implant is stable, and the pathogen is relatively avirulent and sensitive to an orally well absorbed antibiotic. Good results have been achieved under these conditions in staphylococcal infections with rifampin associated with quinolones and other antibiotics, e.g., cotrimoxazole, fusidic acid, and linezolid.

Acetamides↗
PubMed2000

[Cefepime in the treatment of osteomyelitis caused by Gram negative bacilli].

We conducted a prospective, randomized, open-label trial to evaluate the efficacy and tolerability of cefepime in the treatment of osteomyelitis caused by Gram-negative bacilli. Hospitalized patients with diagnosis of osteomyelitis due to Gram-negative bacilli susceptible to cefepime were elegible for enrollment. Cefepime was administered intravenously or intramuscularly (2 g every 8 or 12 hours). Microorganisms were considered susceptible to cefepime when the MIC was <8 mg/l. Forty-five patients with bone infections were enrolled, forty-three with osteomyelitis (22 chronic and 21 acute) and two with arthritis. In the per protocol analysis 42 patients were evaluated: 30 (71.4%) were cured. In the intent to treat analysis 45 patients were evaluated: 33 (73.3%) were cured. Our trial suggests that cefepime is as effective as other modern parenteral beta-lactam antibiotics in the treatment of osteomyelitis due to Gram-negative bacilli.

Acute Disease↗
PubMed1999

Oral ofloxacin versus parenteral imipenem-cilastatin in the treatment of osteomyelitis.

We conducted a prospective, randomized, open-label trial, comparing oral ofloxacin with intravenous imipenem-cilastatin for the treatment of chronic osteomyelitis in order to evaluate the efficacy and tolerance. Hospitalized patients with diagnosis of chronic osteomyelitis and isolation of susceptible organisms to ofloxacin and imipenem/cilastatin were eligible for enrollment. Ofloxacin was administered orally (400 mg every 12 hours), and imipenem-cilastatin was given intravenously (500 mg every 6 hours). Organisms were considered susceptible to ofloxacin when the minimal inhibitory concentration (MIC) was <2 micrograms/ml, and to imipenem-cilastatin when the MIC was <4 micrograms/ml. Thirty-two patients were enrolled, 16 in each group. In the intent to treat analysis 11 (69%) patients in the ofloxacin group and eight (50%) in the imipenem-cilastatin group were cured (p = 0.473; 95% confidence interval of the difference from -14.7% to 52.2%). In the per protocol analysis 10 (91%) patients in the ofloxacin group and seven (70%) in the imipenem/cilastatin group were cured (p = 0.311; 95% confidence interval of the difference from -12.2% to 54%). Our trial suggests that oral ofloxacin is as effective as parenteral therapy with betalactam antibiotics in the treatment of osteomyelitis, which could allow a reduction of the period of hospitalization and economic costs.

Administration, Oral↗
PubMed1992

[The reactive hemophagocytic syndrome associated with immunoblastic B-cell lymphoma].

The reactive hemophagocytic syndrome is a rare clinical-pathological entity which usually has a benign evolution and which is characterized by the systemic proliferation of mature histiocytes, with a great phagocytosis ability and which occurs in a secondary form in some infections and neoplasias and after the administration of certain drugs. We present a case of reactive hemophagocytic syndrome in a patient presenting a non-Hodgkin lymphoma, of crest malignancy, B immunoblastic and kappa monoclonal, with fatal evolution and in which the diagnosis was obtained after necropsy.

Aged↗
PubMed1991

[Cefotaxime treatment of osteomyelitis of the foot in the diabetic].

Osteomyelitis at the base of an ulcer the foot of diabetic patient is a serious complication usually produced because of the patient's neglect, and entailing difficulties in diagnosis and treatment. Several factors (neurological and vascular ...) favor the onset of the initial ulcer and its evolution, the ulcer subsequently converting into the main door for soft tissue infection with extension to the contiguous bone, with a bad prognosis. Cefotaxime is a 3rd generation cephalosporin, active against coccus gram positive and the majority of aerobic gram negative bacillus. This antibiotic was used in 25 diabetic patients with osteomyelitis at a dosage of 2 gr. IV a/d, during at least 30 days, adding metronidazole when anaerobic bacteria were isolated. The number of patients cured were 21 (84%), one improvement (4%), one resistant (4%) and two relapses (8%). There were no secondary effects.

Aged↗