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Biomedical subjects

J Pachón

Publications and source records attributed to J Pachón.

At least 73 records · Page 4Linked to original sources
PubMed1994

[Pulmonary aspiration puncture in the etiological diagnosis of pneumonias].

In pneumonias, the short diagnostic results of non-invasive procedures lead frequently to use invasive techniques, among which we find pulmonary puncture aspiration (PPA). In this study, the profitability of PPA in the diagnosis of pneumonias is evaluated. One hundred and thirteen PPA were performed on 107 patients diagnosed of pneumonia. The PPA was performed with a 22-25 G needle without radioscopic control. Hemocultures were gathered in 104 cases, serological tests for productive agents of atypical pneumonia were applied in 50 cases, sputum test in 95 cases, and bronchofibroscopy with occluded telescopic brush in 25. The PPA had a specificity of 98 percent and a sensibility of 54% which rose to 73% in patients without antibiotic treatment prior to the puncture. Only 10 patients had complications with pneumothorax (9 percent) and four (3 percent) presented hemoptysic sputum. In the 53 patients with a positive PPA, knowledge of an etiological agent allowed the antibiotic treatment to be switched in 32 cases (60 percent). In addition, a decrease in the number of days of hospitalization was confirmed in the group of patients who received an etiological diagnosis while alive (p < 0.03). In conclusion, the PPA is a technique with excellent specificity, acceptable sensitivity, and a short rate of complications which allowed the treatment to be changed in 60 percent of the cases and reduced the number of days of hospitalization for patients who received a diagnosis. Thus, it constitutes a very useful technique in the etiological diagnosis of severe pulmonary infections.

Adult↗
PubMed1993

[Pharmacokinetic study of zidovudine in parenteral drug addicts with human immunodeficiency virus infection].

BACKGROUND: The aim of this study was to know the pharmacokinetics of zidovudine (ZDV) in steady state in patients with infection by the human immunodeficiency virus (HIV) in whom the risk factor was intravenous drug use. METHODS: The study was carried out in 8 patients in stage IV of the Centers for Disease Control (CDC) with no acute intercurrent process, with normal liver and renal function, orally receiving 250 mg of ZDV every 6 hours. Blood samples were taken between 30 and 360 minutes from the last doses taken during fasting. Plasma concentrations of ZDV and glucuronide zidovudine (G-ZDV) were determined by radioimmunoassay with the data being adapted to a monocompartmental pharmacokinetic model. RESULTS: The maximum concentration (Cmax) of ZDV was 0.81 +/- 0.38 microgram/ml demonstrating high interindividual variability with values between 0.35 microgram/ml and 1.45 microgram/ml. The mean Cmax of G-ZDV was 1.44 +/- 0.64 microgram/ml. The mean t1/2 of ZDV and G-ZDV was 1.63 +/- 0.75 hours and 1.12 +/- 0.32 hours, respectively, with values oscillating between 0.99 and 3.14 h in the case of ZDV. The area below the curve concentration/time (AUC) of ZDV was 1.43 +/- 0.34 microgram-h/ml and in the case of G-ZDV the AUC was 2.73 +/- 0.91 microgram-h/ml. Total body clearance (Clb) of ZDV was 2.11 +/- 0.64 l/kg/h and the volume of distribution (Vd) of ZDV was 5.6 +/- 1.73 l/kg. CONCLUSIONS: The results of this study demonstrate that there is a marked interindividual variability in the pharmacokinetics of zidovudine suggesting the need for adapting dosage to patients weight and monitoring plasma concentration.

Acquired Immunodeficiency Syndrome↗
PubMed1993

[Psittacosis of avian origin as etiology of community-acquired pneumonia with severe onset].

We present two cases of community acquired pneumonia (extra-hospital) of severe onset, secondary to Chlamydia psittaci of avian origin. Each patient have bought a parakeet in the same pet-shop, and took care of them personally. Both developed a respiratory insufficiency, one of them needing mechanical ventilation. Out of nine relatives to whom serological determinations were performed, there was evidence of infection in two of them, but only one referred an auto-limited febrile syndrome during that period of time. Psittacosis incidence is discussed as origin of community acquired pneumonias, as well as its epidemiology, diagnosis and treatment.

Adult↗
PubMed1992

[Clinical experience with zidovudine in patients with acquired immunodeficiency syndrome. Analysis of 117 cases. Grupo Andaluz para el Estudio de las Enfermedades Infecciosas].

In order to assess the efficacy and the toxicity of zidovudine in AIDS patients, we have studied, prospectively, 117 patients that were treated with this drug, in several andalusian hospitals between January 1988 and June 1990. Initial dose of the drug was 200 mg every 4 hours. Mean survival was 100% at 6 months and 66.5% at 23 months. Survival at 19 months was higher in ADVP (77%) than in non-ADVP (48%). A positive influence on weight. Karnofsky index and number of opportunistic infections during the six first months of treatment was recorded, benefit that was lost progressively from that moment onwards. Main adverse effects were hematological, 10.1% of the patients requiring transfusions due to hemoglobin lower than 6.5 gr%. The more frequent cause to stop therapy was severe neutropenia (less than 500 neutrophils per mm). We consider that the beneficial effect of zidovudine is only transient, diminishing gradually when the treatment is prolonged. At present doses adverse effects are moderate not being present in most of the patients.

AIDS-Related Opportunistic Infections↗
PubMed1991

[Activity of adenosine deaminase in acute brucellosis and complicated brucellosis].

BACKGROUND: Adenosine deaminase (ADA) is an essential enzyme for the differentiation and proliferation of T lymphocytes and the monocyte-macrophage system. The basic immunitary response of brucellosis is cellular. To this end, ADA activity was evaluated in brucellosis. METHODS: Serum ADA activity was assessed by a colorimetric method in 67 patients with brucellosis, before therapy and at 1, 3 and 6 months of follow up. RESULTS: Serum ADA activity in brucellosis was higher than that in 52 healthy controls, both in those with the acute febrile noncomplicated form (48 patients) and in those with focal symptoms from one organ (19 patients) (p less than 0.0001 and p less than 0.001). There were no differences between both groups of brucellosis. There was a negative correlation between the duration of the disease and ADA activity. After therapy there was a rapid decrease of ADA values, more marked in patients with noncomplicated brucellosis. During the follow up, only one patient had a new increase in ADA activity, coincident with a clinical and bacteriological relapse, and previous to the increase of IgG anti-Brucella titers. CONCLUSIONS: The results indicate that adenosine deaminase activity is increased during the active stage of brucellosis. It can be considered as a biochemical follow up marker of the disease and, probably, as a marker of relapses.

Acute Disease↗
PubMed1990

Multicenter prospective study of treatment of Brucella melitensis brucellosis with doxycycline for 6 weeks plus streptomycin for 2 weeks.

The effectiveness of treating human brucellosis caused by Brucella melitensis with a 6-week course of doxcycline plus streptomycin for 2 of those weeks was analyzed by a multicenter prospective study of 139 patients. Subjects with central nervous system involvement, endocarditis, or spondylitis were excluded from the study. All but 5 of the 139 patients completed the full treatment schedule and became afebrile in the first week of therapy. Four patients suffered relapses during the follow-up period. Of the five patients who did not complete the treatment, two left because of adverse secondary effects (1.4%), another two left for noncomplicance with the treatment (1.4%), and the remaining patient was considered a therapeutic failure because his symptoms persisted after the first week of therapy (0.7%). We concluded that the combination of doxycycline and streptomycin is an effective treatment for the types of brucellosis included in our study.

Adolescent↗
PubMed1989

[Hodgkin's disease associated with infection by human immunodeficiency virus].

We present four patients with Hodgkin's disease and human immunodeficiency virus infection (HIV). Three patients were addicts to parenteral drugs. The disease was very advanced at the time of diagnosis, stage IVB in all cases. Histologic types were mixed cellularity in two cases, nodular sclerosis in one case and it was not typifiable in the remaining case. The disturbances of cell-mediated immunity that the patients presented were those of the acquired immunodeficiency syndrome (AIDS) as well as the infectious complications. Response to treatment was poor with a high incidence of bone marrow toxicity; three patients died during the first 3 months after the diagnosis (X = 7.3 months). We emphasize the necessity of considering different prognostic and therapeutic approaches for the HD in these patients in contrast with those of seronegative patients. We pose some questions suggested by the review of the literature and the data of this series.

Adult↗