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Biomedical subjects

J Calderón Ubeda

Publications and source records attributed to J Calderón Ubeda.

3 recordsLinked to original sources

[Rational use of medications in the treatment of urinary infections].

OBJECTIVES: MAIN: to encourage the rational use of medication in the treatment of uncomplicated acute cystitis (UAC). SECONDARY: to find the most common germs in our area and their sensitivity to medication, the most common anti-microbials used and patients age, and to evaluate the savings made through a policy of rational use of medication.Design. Retrospective, descriptive, observational study. SETTING: La Solana Health Centre jointly with the biochemistry laboratory of the Talavera Area. PARTICIPANTS: Probabilistic randomised sampling of clinical histories of women between 20 and 80 with episodes of UAC (349 in all) between 01/10/95 and 01/10/00. MEASUREMENTS AND RESULTS: First, the laboratory evaluated 591 urine cultures of complicated/uncomplicated UTI from 01/01/00 to 01/10/00, with study of the germs involved and their sensitivities. 373 positives were isolated: E. coli (78.3%), which had the greatest sensitivity to amoxycillin/clavulanic acid, fosfomycin, nitrofurantoin and cefixime; Proteus (7.2%) and Streptococcus D (5.8%). Second, clinical records were analysed for the following: antibiotics (norfloxacine and cyprofloxacine, the most common); length of treatment (average of 6.52.34 days); age of patient (greater number in under-65s). CONCLUSIONS: E. coli is the most common germ in UTI and is highly sensitive to amoxy/clavulanic acid, nitrofurantoin, fosfomycin and cefixime. Resistance to cyprofloxacine and norfloxacine are starting to be significant. In UAC the three-day model should be encouraged for young women; and 7 days is recommended for the over-65s. More rational use of medication would increase efficacy and suppose a considerable economic saving in our area.

Acute Disease↗

[Bowenoid papulosis. Review of 4 cases in a health center].

OBJECTIVE: To check the clinical, histological, evolutionary and therapeutic characteristics of Bowen's Disease. DESIGN: A descriptive study of a crossover type. SETTING: Primary Care and a Dermatology clinic at a Health Centre. PATIENTS: There were 4 adult males, aged between 25 and 31, with pigmented papulosis lesions on their external genitals. Two of them were HIV-positive. MEASUREMENTS AND MAIN RESULTS: Clinical records were used. The diagnosis was confirmed through histological analysis. In all cases the lesions were papulosis, multiple and affecting the external genitals. The patients were clinically controlled until the lesions disappeared. The patients' sexual partners were referred to Gynaecology clinics for examination, but no pathology was found in any of them. CONCLUSIONS: Basic knowledge of Bowen's Disease in Primary Care is important given that it is essential to reach a diagnosis as early as possible, in order to monitor the patient and his partner and so avoid any future complications arising from the pathology's presence, such as tumour processes affecting the uterine cervix. The performance of histological analyses when faced with any suspicious genital lesion must be encouraged, given that this technique is non-aggressive.

Adult↗

[Soft chancroid: 4 clinical cases].

OBJECTIVE: The presentation of four clinical cases of chancroid confirmed by means of a culture for Haemophiullus Ducrey and the checking of its clinical and epidemiological characteristics. SETTING: Dermatology Clinic at the "V Centenario" Health Centre, San Sebastián de los Reyes, Madrid. PATIENTS AND OTHER PARTICIPANTS: Four clinical cases collected between 1988 and 1992. They were characterised by the very painful ulcers on the penis which appeared from 10 to 15 days after possible infection. Two of them had been previously treated with penicillin but showed no improvement. MEASUREMENT AND MAIN RESULTS: Clinical records were consulted and the diagnosis was confirmed by means of microbiological culture. Analyses including VDRL and HIV serologies were performed. All the patients were male: the location was the balanopreputial furrow. In two cases the lesion and the secondary adenopathy were single. In the four the general analysis was normal and serology for syphilis negative. Two were HIV positive. All were cured with a single dose of Ceftriaxon. CONCLUSIONS: Even though the chancroid is not common in our field, it must be identifiable so that a proper differential diagnosis of all genital ulcers can be made, with confirmation by means of a culture in a specific medium. The present first line treatment should be in reach of the Public Health System's family doctors and be initiated at once, given that genital ulcers are a risk factor in HIV transmission. Additionally these patients' HIV antibodies should be studied.

Adult↗