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J Sánchez-Alvarez

Publications and source records attributed to J Sánchez-Alvarez.

6 recordsLinked to original sources
PubMed2006

Efficacy and safety of twice-daily pharmacokinetically enhanced amoxicillin/clavulanate (2000/125 mg) in the treatment of adults with community-acquired pneumonia in a country with a high prevalence of penicillin-resistant Streptococcus pneumoniae.

OBJECTIVES: This randomized, double-blind, non-inferiority trial evaluated the efficacy and safety of pharmacokinetically enhanced amoxicillin/clavulanate 2000/125 mg twice daily versus amoxicillin/clavulanate 875/125 mg three times daily, both given orally for 7 or 10 days, in the treatment of adults with community-acquired pneumonia in Spain, a country with a high prevalence of penicillin-resistant Streptococcus pneumoniae. PATIENTS AND METHODS: Following 2:1 randomization, 566 patients (intent-to-treat population) received either amoxicillin/clavulanate 2000/125 mg (n = 374) or amoxicillin/clavulanate 875/125 mg (n = 192). RESULTS: Among the patients who did not deviate from the protocol (clinical per-protocol population), clinical success at day 21-28 post-therapy (test of cure; primary efficacy endpoint) was 92.4% (266/288) for amoxicillin/clavulanate 2000/125 mg and 91.2% (135/148) for amoxicillin/clavulanate 875/125 mg (treatment difference, 1.1; 95% confidence interval, -4.4, 6.6). Bacteriological success at test of cure in the bacteriology per-protocol population was 90.8% (79/87) with amoxicillin/clavulanate 2000/125 mg and 86.0% (43/50) with amoxicillin/clavulanate 875/125 mg (treatment difference 4.8; 95% confidence interval, -6.6, 16.2). At test of cure, amoxicillin/clavulanate 2000/125 mg was clinically and bacteriologically effective against 7/7 penicillin-resistant Streptococcus pneumoniae (MIC > or = 2 mg/L) isolates (including three amoxicillin non-susceptible strains) and amoxicillin/clavulanate 875/125 mg against 5/5 isolates (including one amoxicillin non-susceptible strain). CONCLUSIONS: Both treatment regimens were well tolerated. Amoxicillin/clavulanate 2000/125 mg was at least as effective clinically and as safe as amoxicillin/clavulanate 875/125 mg in the treatment of community-acquired pneumonia in adults in a country with a high prevalence of penicillin-resistant S. pneumoniae and has a more convenient twice daily posology.

Adult↗
PubMed1997

[Usefulness of preoperative location tests in primary hyperparathyroidism].

The utility of preoperative parathyroid location in primary hyperparathyroidism (pHPT) remains controversial. In this retrospective study are analysed noninvasive techniques prior to surgical neck exploration of 11 patients with pHPT, ten adenomas and one hyperplastic parathyroid glands. Localization test were performed 24 times. Ultrasonography allowed correct localization of 5 of 7 cases, computer tomography 2 of 6, scintigraphy 2 of 4 and nuclear magnetic resonance 1 of 7. This exploration was doubtful in a patient, and two false-positive nuclear magnetic resonance were found. The low yield of these tests makes them unnecessary in the evaluation of patients undergoing surgery for pHPT, because the cost is not justified.

Adult↗
PubMed1994

[Fever of unknown origin and tuberculous aortitis].

We present the case of a silicotic patient, with recurrent febrile episodes during the past three years, who was hospitalized for the study of prolonged fever. In addition to compliance with the criteria of fever from unknown origin (FUO), the patient presented semiology and echocardiogram compatible with infectious endocarditis. Later on, he developed a severe aortic failure refractary to medical treatment and hence, he underwent surgery. The surgical intervention showed an abscess in the aortic root, which resulted to be of a tuberculous origin and an intact aortic valve. The review of the echocardiographic study allowed the detection of an image compatible with aortic abscess. We comment on the characteristic of this rare entity and the peculiarities of this case, which fulfill the criteria of what has been recently named recurrent or episodic FUO and among whose causes Mycobacterium tuberculosis had not been detected up to now.

Aortitis↗
PubMed1993

[Still's disease: atypical manifestations and potential markers of severe visceral disease].

We present two patients with Still's disease which, in addition to the typical clinical manifestations, showed rare visceral alterations. The first case referred abdominal pain and a sustained hyperamilasemia was detected. The second case suffered a severe multiple organic failure, characterized by hepatic failure, with electric signs of encephalopathy, hydroelectrolytic disorder, rhabdomyolysis and disseminated intravascular coagulation. During this episode, we detected hyponatremia, reduction of leukocytes and normalization of GSR, modifications already described by other authors in cases similar to these ones, although without considered relevant until now. We comment these results and their value as markers of visceral affectation.

Adolescent↗