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Biomedical subjects

J M Arribas

Publications and source records attributed to J M Arribas.

At least 19 recordsLinked to original sources
PubMed2002

Eikenella corrodens brain abscess after repeated periodontal manipulations cured with imipenem and neurosurgery.

Eikenella corrodens is a facultatively anaerobic gram-negative rod that colonizes the oral cavity and very rarely produces central nervous system (CNS) infections. Frontal lobe abscesses are occasionally associated with a dental source of infection. We report a case of an adult man with overzealous dental cleaning habits who developed a right frontal brain abscess caused by E. corrodens. He underwent neurosurgical drainage of the pus and was successfully treated with imipenem 4 g/i.v./day for 4 weeks with no complications. Repeated periodontal trauma could explain the Eikenella brain abscess in this case.

Anti-Bacterial Agents↗
PubMed2002

[Anaplastic large cell lymphoma. Report of an unusual case].

An anaplastic large cell lymphoma which fulfills all the criteria required for its inclusion among the soft tissue forms is reported. We point out in this case, in addition to its low frequency in adults, the severe systemic involvement of the disorder with out generalization, the lack of expression of the ALK1 protein, frequently positive in the generalized forms and the absence of response to polichiomiotherapy. We think that this case emphasizes the heterogenicity if the disorder on the clinical pathologycal relation ship of this kind of lymphomas.

Aged↗
PubMed2001

[Postsurgical meningitis caused by Acinetobacter baumannii: study of 22 cases and review of the literature].

BACKGROUND: Postsurgical Acinetobacter baumannii meningitis is associated with relevant morbidity and mortality. It has been related to neurosurgery, intraventricular catheters (IC) or CSF fistula. Thus, features, epidemiology and clinical course of this infection were studied. METHODS: Retrospective analysis of 22 episodes of nosocomial postsurgical Acinetobacter baumannii meningitis. Twenty episodes occurred in males. The mean age of patients was 46 years (range: 16-83 years). RESULTS: All patients were admitted to the ICU. In 50% of patients a history of intraventricular hemorrhage was recorded, 36% had had a skull fracture and the remaining patients had a brain tumor. In 18 cases the portal of entry was considered to be IC, in two an epidural catheter, and in two a CSF fistula. Patients showed a clinical picture indistinguishable from other types of meningitis, fever being the most common symptom (100%). CSF findings were consistent with bacterial meningitis. In one case the microorganism was recovered from blood. Fifteen patients recovered, three died as a direct result of the infection, and the remaining patients relapsed. Non recovery of patients was significantly associated with non removal of catheter (p < 0.05). CONCLUSIONS: Postsurgical Acinetobacter baumannii meningitis occurs frequently in patients previously colonized with this microorganism in other sites and is enhanced by the presence of an IC. Catheter removal is essential for recovery of patients.

Acinetobacter Infections↗
PubMed2001

[Acute infectious lymphocytosis associated to Giardia lamblia and Blastocystis hominis coinfection].

Acute infectious lymphocytosis is characterized by marked peripheral blood lymphocytosis, often associated with a mild, nonspecific febrile illness. We present a 4-year-old girl with acute infectious lymphocytosis associated with Giardia lamblia and Blastocystis hominis coinfection. Analysis of peripheral lymphocyte markers showed overall proliferation of B and T cells with a reduction in the proportion of T cells, especially in the CD4T cell subpopulation. Hematologic values returned to normal after treatment with metronidazole.

Acute Disease↗
PubMed1999

[Progressive multifocal leukoencephalopathy associated with human immunodeficiency virus infection: the clinical, neuroimaging, virological and evolutive characteristics in 35 patients].

BACKGROUND: The clinical, neuroimaging, virologic and evolutive characteristics of progressive multifocal leukoencephalopathy (PML) in 35 AIDS patients are studied. PATIENTS AND METHODS: PML was diagnosed by clinical and neuroimaging criteria in 32 patients and by autopsy in other three. The detection of JC virus (JCV) was done by PCR and further hybridization of the amplified DNA in peripheral blood lymphocytes, urine and CSF. RESULTS: 127 of 930 HIV positive patients were admitted by neuropsychiatric symptoms and of them 35 (SD 27.6%) by PML. The PML patients had a mean CD4 lymphocytes count of 75.3 (82.0)/x 10(6)/l and a HIV viral load of 330,698 (538,971) copies of RNA/ml. Thirty patients did not receive any anti-retroviral therapy or only transcriptase inhibitors monotherapy and five triple anti-retroviral therapy, including a proteases inhibitor. Multiple hypodense lesions on CT (53.1%) and T2 hyperintense lesions on MRI (58.3%) were the most frequent neuroimaging findings. JCV was detected in 20/21 (95.2%) LMP patients: 18/19 detections in lymphocytes, 6/8 in CSF and 4/6 in urine. The mean survival without and with antiretroviral therapy were 3.0 (0.47) and 21.4 (4.4) months (p < 0.001) in 34 patients followed. PML progressed to death in 31/34 patients (91.2%), and remained stable in 3/34 (8.8%). A patient was lost for follow-up. CONCLUSIONS: The application of clinical and neuroimaging criteria and the detection of JCV in CSF are useful for high presumption diagnosis of PML without brain biopsies. JCV detection in lymphocytes and in urine have a much lower predictive value. The evolution and survival of this disease can improve with triple anti-retroviral therapy including a protease inhibitor.

AIDS-Related Opportunistic Infections↗
PubMed1999

[Incidence of primary gastric lymphoma and H. pylori infection in the central zone of Asturias].

OBJECTIVE: We review our experience with primary gastric lymphomas type B of low (MALT) and high grade in a population of 366,635 people during 4 years and after performing 9,268 gastroscopies. RESULTS: The incidence of these lymphomas in our medium is similar to that found in the world population. Possible disagreements among the biopsy histology and that of the subsequent gastrectomy samples is pointed out. CONCLUSIONS: The frequency of H. pylori involvement in our primary gastric lymphomas is similar to that reported in the literature for the age of our patients, for the MALT lymphomas an well as for the type B high grade.

Aged↗
PubMed1997

Bactericidal effect of ADP and acetic acid on Bacillus subtilis.

Bacillus subtilis is a ubiquitous soil bacterium used for measuring the beta-lysin activity and in other bioassays. We observed a complete bactericidal effect of ADP on B. subtilis at concentrations of 50-100 microM at pH values <5.5, which disappeared at pH values above 6. The effect was also found for acetic acid at concentrations >17.4 microM and similar pH values. ATP, adenosine, and HCl were not bactericidal. We used BCECF-AM, a pH-sensitive probe, and found that the killing of B. subtilis was due to a change in the intracellular pH caused by the passage across the cell membrane of these weak organic acids when incubated with B. subtilis at pH values near the pK. More experiments are needed to determine the biological meaning of these in vitro findings.

Acetic Acid↗
PubMed1997

[Pseudomonas aeruginosa bacteremia as a complication after endoscopic retrograde cholangiopancreatography].

BACKGROUND: The present was performed to describe the characteristics of bacteremias by Pseudomonas aeruginosa following cholangiopancreatography and the methods of prevention and treatment of the same. METHODS: Twelve different episodes of bacteremia by Pseudomonas aeruginosa were retrospectively studied in patients submitted to endoscopic cholangiopancreatography (ERCP) from 1993-1997. RESULTS: Three point six percent of the patients undergoing ERCP presented episodes of bacteremias by the microorganism in the 48 hours following the procedure. Except for one case, the patients presented obstructive disease in the form of calculi or neoplasms at the level of the biliary tree. In three cases, sphincterotomy had been carried out which was followed by clinical manifestations of hemorrhage in one case. Three patients (25%) died as a consequence of bacteremia and a hepatic abscess was developed in one case. The bacteremia appeared in successive outbreaks from 1993-1997. CONCLUSIONS: Bacteremia by Pseudomonas aeruginosa following ERCP is more frequent in patients with obstructive disease of the biliary tract and has an important additional morbimortality. It is associated with incorrect endoscopic disinfection. The use of drugs with an antipseudomonal spectrum should be considered as preendoscopic prophylaxis.

Adult↗
PubMed1996

Imipenem therapy of brain abscesses.

The efficacy of imipenem versus standard chemotherapy (both in addition to neurosurgery) in the treatment of brain abscess was compared in a retrospective study. Cure was obtained in 52 of 60 (86.7%) patients in the standard group, and in 15 of 15 (including 5 patients with multiple brain abscesses) in the imipenem group. Cure without neurosurgery was observed in 2 of 60 (3.3%) and 3 of 15 (20%) of the cases, respectively (p = 0.08). Levels of imipenem in blood, cerebrospinal fluid, and brain pus were above the minimum inhibitory concentrations of most of the abscess isolates. Side effects of imipenem were rare and tolerance was excellent. Imipenem monotherapy (3-4 g/day) for five weeks seems a reasonable therapeutic choice for treatment of bacterial brain abscesses.

Adolescent↗
PubMed1996

Airways reactivity, atopy and bronchoalveolar lavage in male smokers with airflow obstruction.

Although cigarette smoking plays a major role in the development of chronic obstructive pulmonary disease, risk factors that might predispose susceptible smokers to develop manifest airflow obstruction are poorly defined. The aim of this study was to investigate whether BAL cell profiles, bronchial hyperresponsiveness, and atopy were different in smokers with and without airway obstruction. Fifty-seven current smokers with (n = 22) and without airflow obstruction (n = 35), defined spirometrically, and 8 nonsmoking subjects (controls) were studied (fiberoptic bronchoscopy and bronchoalveolar lavage (BAL), measurement of IgE concentrations and skin prick testing with common allergen extracts, methacholine bronchoprovocation testing). Mean values of forced expiratory volume in 1 s (FEV1) percent predicted were significantly lower in smokers with obstruction than in those without obstruction (53.1 +/- 16.9 vs. 72.5 +/- 16.6, p < 0.001). Smokers with airflow obstruction showed an improvement in FEV1 < 20% after inhalation of two puffs of 0.250 mg terbutaline. Current smokers as opposed to controls had significantly (p < 0.01) higher values of cells/ml in BAL (78 +/- 72.4 x 10(4) vs. 28.7 +/- 14.5 x 10(4)) and macrophages (90.5 +/- 19.4 vs. 84.3 +/- 9.3%) and lower values of lymphocytes (5.4 +/- 15.4 vs. 13.1 +/- 10.7%). Smokers with obstruction to airflow showed significantly (p < 0.05) higher values of cells/ml in BAL (102 +/- 88 x 10(4)) than smokers without airflow obstruction (63.4 +/- 57.5 x 10(4)) with no differences in differential cell counts. The provocation concentration of methacholine producing a 20% reduction in FEV1 (PC20) was also lower in smokers with obstruction than in smokers without obstruction (2.9 +/- 3.5 vs. 6.4 +/- 7.2 mg/ml, p < 0.05). Differences in atopy were not found. In summary, current smokers with airflow obstruction tended to have more cells recovered by BAL and greater airway responsiveness than smokers without obstruction, although atopy-related parameters were not different for both groups.

Aged↗
PubMed1996

[Castleman's disease: a histological concept for a wide clinical spectrum].

A literature review about Castleman's disease after a clinical case with different manifestations of this entity was done. Special emphasis on the histological and clinical aspects of the sickness was given. The different pathological patterns and their broader spread do not match necessarily with the different clinical presentations described. Further conclusions regarding their evolution, prognosis and treatment response can not be easily obtained from these data.

Castleman Disease↗
PubMed1996

[Severe orbital cellulitis: therapeutic results in 9 patients and review of the literature].

BACKGROUND: Orbital cellulitis can produce severe neuromeningeal infections. Modern antimicrobial agents such as imipenem can be a valid therapeutical choice. METHODS: Patients with severe or complicated orbital cellulitis admitted to our hospital from 1986 through 1994 were retrospectively studied. RESULTS: Nine patients with severe orbital cellulitis, seven of them older than 14 years, are reported. Cellulitis was secondary to different forms of sinusitis in five of them. The incriminated microorganisms were: Streptococcus viridans alone or combined to gram negative bacilli (3 cases), Prevotella melaninogenica and other anaerobes (2 cases), Enterococcus faecalis and Staphylococcus aureus (one case each). Three patients developed brain abscesses, one an acute bacterial meningitis and another a subdural empyema. Eight patients underwent a surgical drainage. Seven patients were treated with IV imipenem at doses of 2-3 g/day with complete cure of the orbital cellulitis and of the associated infectious complications and no secondary effects. Two patients died. CONCLUSIONS: Imipenem is an effective antibiotic in the combined medical-surgical treatment of the severe or complicated orbital cellulitis.

Adolescent↗
PubMed1995

[Infectious endocarditis of the native valve: its epidemiological profile and an analysis of its mortality between the years 1984 and 1993].

BACKGROUND: The description of the epidemiologic profile and analysis of the mortality of infectious endocarditis (IE) observed from 1984-1993. METHODS: One hundred thirty episodes of IE in a native valve (30 in drug addicts [IVDA] and 20 cases of nosocomial acquisition) were analyzed with right/left/bilateral localization (42/84/4, respectively), infection of the mitral/aortic/tricuspid valve (52/47/34, respectively) and the etiology was determined as Staphylococcus aureus in 52 cases, 41 Streptococcus, 13 negative coagulase Staphylococcus, and 11 Enterococcus. High risk IE were identified by uni and multivariate analysis (MVA). RESULTS: The incidence of IE ranged from 0.36 and 0.70 cases x 1.000 admitted adults/year (mean: 0.50). Transthoracic echocardiography detected bacterial vegetations in 67% of the cases with the validity to predict the development of embolisms being 55%. MVA showed the embolic episodes (present in 45% of the IE) to be associated with the IVDA patients and prolonged fever. The latter complication, being defined as > or = 10 days of fever under appropriate treatment, was observed in 32% of the cases and was due to mild (n = 15) and severe causes (n = 27). Postembolic septic complications were associated to fever with MVA. Twenty three patients died (18%), 2 IVDA and 5 nosocomial IE, mainly due to heart failure (n = 13). The independent risk factor predictors for death (p < 0.05) were: age > or = 60 years (mortality 34%), cerebral embolisms (55%), severe heart failure (37%), and the exclusion of the patient as a candidate for surgery (73%). To the contrary, right IE (mortality 0%) and cardiac surgery (5%) favoured survival. CONCLUSIONS: To improve the prognosis of infectious endocarditis in high risk patients more opportune cardiac surgery accepting greater risks should be performed.

Adult↗