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J M Reguera

Publications and source records attributed to J M Reguera.

10 recordsLinked to original sources
PubMed1996

Complications associated with Brucella melitensis infection: a study of 530 cases.

We carried out a prospective study of 530 patients older than 14 years of age with brucellosis. We describe the incidence and clinical features of the focal forms of the disease, analyzing some of the possible factors associated with their appearance. One hundred sixty-nine patients (31.9%) had a focal form or complication. Osteoarticular complications were the most frequent, totaling 113 cases (66%), followed by genitourinary with 18 cases (5.1% of males), hepatic (2.5%), neurologic (1.7%), and heart (1.5%). Nine patients (1.7%) had more than 1 complication. In a multivariate analysis, diagnostic delay greater than 30 days (OR 2.0), ESR > 40 mm/hr (OR 1.9), and levels of alpha-2 globulin > 7.5 g/L (OR 6.8) were statistically significant independent variables associated with the presence of focal forms. Twenty-five patients with complications (14.8%) required surgical treatment. The relapse rate was 3.6% for those patients without complications and 4.1% for patients with focal forms (p > 0.05). However, when therapeutic failure, relapses, and mortality were considered together, the risk of an unfavorable evolution was significantly greater in patients with focal forms (10.6% versus 3.6% in patients without complications; OR 1.9, 95% CI 1.4-7.1, p < 0.005). Given the worse prognosis, knowledge and early diagnosis of the focal forms of B. melitensis infection is especially important.

Adolescent↗
PubMed1994

Phagocytic cell function in active brucellosis.

In this study, we analyzed phagocytic cell function in 51 patients with active brucellosis and its relationship with different clinical, serological, and evolutionary variables. A control group was made up of 30 blood donors of similar geographic extraction, age, and sex, with no previous history of brucellosis or known exposure ot the infection or specific antibodies. The investigations were carried out at the time of diagnosis, at the conclusion of treatment, and after 6 months of follow-up. Polymorphonuclear leukocyte adherence and nitroblue tetrazolium reduction in response to Brucella antigen were significantly increased in the patients at the time of diagnosis with respect to the control group. In contrast, chemotaxis in response to Brucella antigen and phagocytosis were significantly reduced in the patients with respect to the control group. The alterations in phagocytic cell function were greater in patients with bacteremia, with focal forms of the disease, or with a longer diagnostic delay. Most of these initial alterations tended to normalize with treatment, indicating their transient character.

Adolescent↗
PubMed1994

[Evaluation of the Chromotitre EIA test in the diagnosis of human brucellosis].

BACKGROUND: The aim of the study was to evaluate the diagnostic efficacy of Chromotitre EIA test for the diagnosis of human brucellosis and compare the same with other classical serologic test. METHODS: A prospective study was performed in 50 patients with active brucellosis. Thirty blood donors, 64 patients with different neoplastic and autoimmune infectious processes, 20 patients with history of brucellosis and 8 subjects with continuous exposure to Brucella at work were analyzed as the control group. RESULTS: Forty-five patients with brucellosis (90%) presented a positive IgM or IgG ELISA, 32 (62%) only IgM, 34 (68%) only IgG and 22 (44%) both immunoglobulins were positive. The sensitivity and specificity of ELISA test jointly evaluating IgM and IgG was 90 and 68%, respectively with these numbers being 62 and 98% and 68% and 38% for ELISA IgM and ELISA IgG. A moderate correlation was found between ELISA IgM with Bengal's Rose test (r = 0.53, p = 0.003) and sero-agglutination (r = 0.63, p = 0.0001) and ELISA IgG with the Coombs test (r = 0.55, p = 0.003). Only acceptable concordance was observed between ELISA IgM and sero-agglutination (kappa = 0.55, p = 0.0001). CONCLUSIONS: The ELISA test evaluated was very useful for the detection of IgM antibodies but was found to be insufficient with respect to IgG antibodies. Despite the slight diagnostic efficacy of the ELISA IgG the combined parallel use of both immunoglobulins achieved a performance similar to that achieved with the classical tests.

Adolescent↗
PubMed1991

Osteoarticular complications of brucellosis.

Two hundred and sixty three patients with a diagnosis of brucellosis between January 1984 and December 1987 were studied prospectively. Sixty five patients (25%) developed osteoarticular complications. These patients had a more prolonged course than those with no complications. Spondylitis in 38 (58%) and sacroiliitis in 29 (45%) were the most prevalent. There were no significant laboratory, serological, or bacteriological differences between patients with and without osteoarticular complications. At diagnosis 47 patients (72%) showed radiographic abnormalities, commonly in axial sites but rarely in peripheral sites. Radionuclide bone scan was positive with no radiographic abnormalities in 17 (26%) of cases. Fifty seven patients received medical treatment alone, 51 (89%) being cured with a single course of treatment. Treatment failed or there was a relapse in six patients (11%), of whom five had spondylitis. Eight of the 65 patients (12%), all of whom had spondylitis and paravertebral or epidural abscesses, also required surgical treatment.

Adolescent↗
PubMedDate not supplied

Serology, clinical manifestations and treatment of brucellosis in different age groups.

We prospectively studied 339 patients diagnosed of brucellosis over a six year period in order to evaluate the clinical and serological characteristics of brucellosis in the elderly. 319 patients (94.1%) were under 65 years of age (group A), and 20 patients (5.9%) were older than 65 (group B). No patient in group B developed splenomegaly as opposed to 69 (21.6%) in group A (p less than 0.05). The percentage of positive blood cultures (Brucella melitensis isolated in all cases) was 72.1% in group A and 60% in group B. The mean titer of IgM antibodies measured by indirect immunofluorescence test was significantly lower in the elderly patients, with no other differences in serologic response between the two groups. 103 patients (32.2%) in group A and seven patients (35%) in group B developed some complications; spondylitis was more common and severe among group B patients. There was no therapeutic failure or relapse among patients over 65. We conclude that clinical, bacteriological and serological characteristics and the outcome of brucellosis in the elderly are similar to those seen in younger patients.

Adolescent↗
PubMedDate not supplied

[Combined use of rose Bengal and indirect immunofluorescence in the diagnosis of brucellosis].

In the present prospective study we have evaluated the sensitivity, specificity and predictive value of the Bengal rose and indirect immunofluorescence (IIF) in 122 patients with a bacteriological diagnosis of brucellosis. The sensitivity of the Bengal rose was 95.79% and its specificity 98.43%. IIF had a sensitivity of 68.80% and a specificity of 100% when the polyvalent anti-IgS conjugate was used. The combined parallel use of Bengal rose and IIF-IgS resulted in a sensitivity of 89.17% and a specificity of 100%. There was a good correlation between Bengal rose and serum agglutination test (r = 0.72); on the contrary, there were not good correlations between the fluorescent conjugates and Bengal rose, agglutination and Coombs test. In conclusion, the combined use of Bengal rose as a screening test and IIF as a confirmation study is a good diagnostic strategy for human brucellosis.

Agglutination Tests↗