Erdheim-Chester disease.
Explore the source record for details and available documents.
Diagnosis, Differential↗
Biomedical subjects
J Sala
Publications and source records attributed to J Sala.
Six-month outcome in unstable angina patients without previous myocardial infarction according to the use of tertiary cardiologic resources. RESCATE Investigators. Recursos Empleados en el Síndrome Coronario Agudo y Tiempos de Espera.
OBJECTIVES: The study assessed whether varying accessibility of patients with unstable angina (UA) to coronary angiography and revascularization determined differing usages and outcomes. BACKGROUND: The appropriate use rate of coronary angiography and revascularization procedures in UA remains to be established. METHODS: A total of 791 consecutive patients with UA without previous acute myocardial infarction (AMI) admitted to four reference teaching hospitals (one with tertiary facilities) were followed for six months. End points were six-month mortality and readmission for AMI, UA, heart failure, or severe ventricular arrhythmias. RESULTS: Patients admitted to the tertiary hospital were 3.27 (95% confidence interval [CI] 2.32 to 4.62) times more likely to undergo coronary angiography after adjustment for comorbidity and severity than were those admitted to nontertiary facilities (overall six-month use rates 70.1% and 48.3%, respectively). Revascularization procedures were performed in 36.2% of patients in the tertiary hospital and 24.6% in the others (p = 0.0007); adjusted relative risk (RR) 2.37 (95% CI 1.55 to 3.63). Median delay for urgent coronary angiography was shorter in the tertiary hospital (24 h vs. 4 days, p < 0.0002). Six-month mortality and readmission rates were similar in tertiary and nontertiary hospitals: 3.9% versus 5.3% and 16.9% versus 21.2%, respectively. Adjusted RR of death or readmission for the nontertiary hospitals was 1.23 (95% CI 0.57 to 2.67). CONCLUSIONS: The use of coronary angiography and revascularization procedures in UA patients with no previous AMI is higher in tertiary than in nontertiary hospitals, but the more selective use of these procedures in nontertiary centers does not imply worse outcome.
Aged↗
Prevalence of Salmonella serotypes in environmental waters and their relationships with indicator organisms.
The incidence of serotypes of Salmonella in three types of environmental water (sea, river and fresh reservoirs) from north-east Spain was investigated. The study was performed at specific sampling locations during the summer for a period of five years (1992-1996). A total of 823 strains were isolated and 55 different serotypes were identified, 42 were recovered from sea water, 32 from river water and 12 from freshwater reservoirs. The most frequently isolated serotypes coincided with those involved in clinical cases in the area studied. Salmonella enteritidis was the most common (111 isolates), it was found in all types of water, although most predominantly in sea water (16.1% of the isolates). This serotype, together with S. hadar, significantly increased in frequency during the five year study period. The most frequent serotypes in river water and freshwater reservoirs were S. virchow (9.5%) and S. mikawasima (23.8%) respectively. Significant differences were assessed in the indicator organism densities between the samples with serotypes of clinical significance (S. enteritidis, S. infantis, S. typhimurium, S. virchow and S. paratyphi B) and those without clinical significance. Therefore their presence in all environmental waters may be of epidemiological significance.
Fresh Water↗
Antimicrobial susceptibility testing of dematiaceous filamentous fungi: effect of medium composition at different temperatures and times of reading.
We examined the effects of the composition of five media on the MICs of three antifungal agents (amphotericin B, flucytosine and ketoconazole) against 24 dematiaceous fungi at different temperatures and times of reading. Media studied were RPMI 1640, tryptic soy broth (TSB), yeast nitrogen broth (YNB), casein-yeast-glucose broth (CYG) and high-resolution medium (HR). The degree of reproducibility was determined with ketoconazole and 5-fluorocytosine and the media TSB and RPMI showed the best results with ketoconazole, while the best results for flucytosine were in CYG. Reproducibility was higher at 25 degrees than at 30 degrees C. The media and incubation time were shown to have a significant influence on the MICs of the three antifungals, but there were no interactions between these variables and temperature, except in the case of ketoconazole, where media-temperature and media-incubation time interactions were significant. There were noteworthy differences between the MICs obtained with the different media.
Amphotericin B↗
A way of obtaining isoresource consumption care episodes.
The purpose of this study is to identify groups of care episodes that involve pneumologic and cardiologic problems and that exhibit homogeneous patterns of frequentation and diagnostic test consumption in an ambulatory consulting room. A 1-year prospective study of care content was done, and the episodes were retrospectively analyzed 2 years later. Data were collected in an ambulatory cardiologic and pneumologic consulting room in Spain. Nonlinear principal components analysis was applied before cluster analysis. Five typologies with a homogeneous pattern of resource consumption were obtained: three related to acute episodes of care and two to chronic ones.
Adolescent↗
Sex differences in survival rates after acute myocardial infarction.
Explore the source record for details and available documents.
Global Health↗
Mortality differences between men and women following first myocardial infarction. RESCATE Investigators. Recursos Empleados en el Síndrome Coronario Agudo y Tiempo de Espera.
CONTEXT: Mortality after acute myocardial infarction is worse in women than in men, even after adjustment for comorbidity and age dissimilarities between sexes. OBJECTIVE: To assess the influence of sex on survival after acute myocardial infarction. DESIGN: Inception cohort obtained in a prospective registry of patients with acute myocardial infarction from 1992 through 1994. SETTING: Four teaching hospitals in northeastern Spain. PATIENTS: All consecutive patients aged 80 years or younger with first acute myocardial infarction. A total of 331 women and 1129 men were included. MAIN OUTCOME MEASURE: Survival at 28 days and mortality or readmission at 6 months. RESULTS: Women were older (mean, 68.6 vs 60.1 years), presented more often with diabetes (52.9% vs 23.3%), hypertension (63.9% vs 42.3%), or previous angina (44.6% vs 37.4%), and developed more severe myocardial infarctions than men (acute pulmonary edema or cardiogenic shock occurred in 24.8% of women and 10.5% of men) (all P<.02). Men were more likely than women to receive thrombolytic therapy (41.3% vs 23.9%; P<.001), but rates of percutaneous transluminal angioplasty and coronary artery bypass graft surgery at 28 days were similar among men and women. The 28-day mortality rate was significantly higher among women (18.5% for women, 8.3% for men; P<.001). Revascularization procedures at 6 months were performed in a similar proportion of women and men. However, women had higher 6-month mortality rates (25.8% in women, 10.8% in men; P<.001) and readmission rates (23.3% for women, 12.2% for men; P<.001). After adjustment, women had greater risk of death than men at 28 days (odds ratio [OR], 1.72; 95% confidence interval [CI], 1.12-2.65) and at 6 months (OR, 1.73; 95% CI, 1.18-2.52). CONCLUSIONS: In this study population, women experienced more lethal and severe first acute myocardial infarction than men, regardless of comorbidity, age, or previous angina.
Aged↗
Relationship between presence of Salmonella and indicators of faecal pollution in aquatic habitats.
The presence of Salmonella and its relationship with indicators of faecal pollution was investigated in aquatic habitats. The highest frequency was obtained in rivers (58.7% of samples) followed by freshwater reservoirs (14.8%) and sea water (5.9%). The sporadic presence of Salmonella (< 30%) on beaches with low concentrations of faecal streptococci (mean 25 CFU (100 ml)-1) may represent a potential risk for bathers in agreement with data found in previous epidemiological studies. Absence of Salmonella was observed only on beaches with very low densities (CFU (100 ml)-1) of indicator organisms (25 total coliforms, 13 faecal coliforms and 17 faecal streptococci).
Bathing Beaches↗
[Anthropometric and dietary determinants of blood levels of HDL cholesterol in a population-based study. The REGICOR study. Researchers of the REGICOR study].
OBJECTIVES: The aim of the present study was to identify dietary and anthropometric factors influencing HDL cholesterol levels in the region of Girona. POBLATION AND METHODS: A cross-sectional study was designed with random recruitment and 798 men and 862 women were included. Anthropometric variables were collected, the energy expenditure in physical activity was calculated and a dietary questionnaire was supplied in order to obtain nutritional data. Furthermore, lipid levels and lipoprotein concentrations were determined. RESULTS: Significant differences were found in serum triglycerides, body mass index, glucose levels and alcohol intake between the upper and the lower tertils of HDL cholesterol in both men and women. In men, energy expenditure in physical activity was significantly associated with HDL cholesterol levels, as well as total fat and monounsaturated fat. In women, together with the waist-to-hip ratio and fasted glycemia, vitamin C was the dietary factor positively associated with HDL cholesterol levels. CONCLUSIONS: Moderate alcohol intake, physical activity, vitamin C consumption and optimizing body weight strongly contribute to increased HDL cholesterol levels in our region.
Adult↗
Acute myocardial infarction case fatality, incidence and mortality rates in a population registry in Gerona, Spain, 1990-1992. REGICOR Investigators.
BACKGROUND: Community-based registries provide the best approach to assessing the impact of myocardial infarction (MI) in a population. The objective of the present study was to determine MI mortality, incidence, attack rate and 28-day case fatality in the province of Gerona, Spain from 1990 to 1992. METHODS: Standardized methods were used to find, register and classify MI cases in that population (509628 inhabitants) as definite, possible and insufficient-data MI. RESULTS: Of the 1456 cases fulfilling eligibility criteria, 850 (58.4%) were classified as definite MI, 162 (11.1%) as fatal possible MI, 232 (15.9%) as no MI and 160 (11.0%) as fatal insufficient data. The 1990-1992 age-standardized incidence rates (first MI cases only) for definite and fatal possible MI were 140.8 per 100000 men and 20.4 per 100000 women, all aged 35-64 years; attack rates (first and recurrent MI cases) were 182.9 and 24.5, and mortality rates 46.4 and 5.8, respectively. Case fatality at 28 days was 27.4% and 19.9% in men and women, respectively, but women died later over that period. With respect to men, the age-adjusted risk among women of dying within 28 days post-MI was 1.26 (95% confidence interval [CI]: 0.94-1.69). CONCLUSIONS: Myocardial infarction, incidence, mortality rates and case fatality in Gerona are among the lowest in the world. Age-adjusted case fatality within 28 days is only marginally higher in women than in men, but fatal cases occur later within this period in women.
Adult↗
Antifungal susceptibilities of Paecilomyces species.
The MICs and minimum fungicidal concentrations (MFCs) of amphotericin B, miconazole, itraconazole, ketoconazole, fluconazole, and flucytosine for 52 isolates of Paecilomyces species were evaluated by the broth microdilution method, largely based on the recommendations of the National Committee for Clinical Laboratory Standards (document M27-A). The fungal isolates tested included 16 P. variotii, 11 P. lilacinus, 9 P. marquandii, 6 P. fumosoroseus, 4 P. javanicus, and 2 P. viridis isolates and 1 isolate of each of the following species: P. carneus, P. farinosus, P. fulvus, and P. niveus. The MFCs and the MICs at which 90% of isolates were inhibited (MIC90s) for the six antifungal agents were remarkably high; the MIC50s indicated that amphotericin B, miconazole, itraconazole, and ketoconazole had good activities, while fluconazole and flucytosine demonstrated poor efficacy. The ranges of the MICs were generally wider and lower than those of the MFCs. There were significant susceptibility differences among the species. All species with the exception of P. variotii were highly resistant to fluconazole and flucytosine; P. variotii was susceptible to flucytosine. Amphotericin B and the rest of the azoles showed good activity against P. variotii, while all the antifungal agents assayed showed low efficacy against P. lilacinus.
Antifungal Agents↗
High prevalence of cardiovascular risk factors in Gerona, Spain, a province with low myocardial infarction incidence. REGICOR Investigators.
STUDY OBJECTIVE: To establish the prevalence of main cardiovascular risk factors in the province of Gerona, where the incidence of myocardial infarction is known to be low. DESIGN: This was a cross sectional study of prevalence of cardiovascular risk factors conducted on a large random population sample. SETTING: The province of Gerona, Spain. PARTICIPANTS: Two thousand four hundred and four eligible inhabitants of Gerona aged between 25 and 74 years were randomly selected for a multi-stage sample stratified by age and sex. The following were standardly measured: lipids (total cholesterol, high density, low density, lipoprotein (a) and triglycerides), fibrinogen, basal glycaemia, arterial pressure, anthropometric variables, smoking, history of angina (Rose questionnaire), and a medical history questionnaire. Population measurements were standardised for the world population of 24 to 74 years of age. RESULTS: The participation rate was 72.7% (1748). Total mean cholesterol was 5.69 mmol/l in men and 5.61 mmol/l in women and mean high density cholesterol was 1.22 mmol/l and 1.47 mmol/l, respectively. Median lipoprotein (a) was 0.22 g/l. These three lipids increased significantly with age. Mean fibrinogen was 2.92 g/l in men and 3.09 g/l in women, and was higher in smokers. The prevalence of hypertension (systolic arterial tension > or = 140 mm Hg or diastolic > or = 90 mm Hg or drug treatment) was 31.3% in men and 27.7% in women. The proportion of male smokers was 33.8% and female smokers 22.7%. The proportion of female smokers in the 25-34 year age group exceeded that of the remaining age groups for both men and women. CONCLUSIONS: The prevalence of cardiovascular risk factors in Gerona is relatively high for the low myocardial infarction incidence typical of the area, although similar to that of other Spanish areas. The factors that confer sufficient protection to compensate for the effect of the prevalence of these risk factors remain to be elucidated.
Adult↗
Six-month outcome in patients with myocardial infarction initially admitted to tertiary and nontertiary hospitals. RESCATE Investigators. Recursos Empleados en el Síndrome Coronario Agudo y Tiempos de Espera.
OBJECTIVES: The aim of the present study was to ascertain whether the degree of accessibility to coronary angiography and revascularization results in differing usages or outcomes, or both, in the setting of a high coverage national health system. BACKGROUND: The selective use of coronary angiography and revascularization procedures in the management of acute myocardial infarction (MI) remains controversial. METHODS: A cohort of 1,460 consecutive patients with a first MI admitted to four referral teaching hospitals (one with tertiary facilities) were followed up for 6 months after admission. Only patients initially admitted to each of the study hospitals were retained for analysis in the original hospital's cohort. End points were 6-month mortality and readmission for reinfarction, unstable angina, heart failure or severe ventricular arrhythmia. RESULTS: Patients admitted to the tertiary hospital were more likely to undergo coronary angiography (adjusted relative risk 4.22, 95% confidence interval [CI] 3.37 to 5.45) than those admitted to the nontertiary sites (use rate: 22.1% for nontertiary care, 55.5% for tertiary care). Revascularization procedures were performed in 21.2% of patients in the tertiary hospital and in 8.3% in the nontertiary hospitals (p < 0.0001). Median delay for emergency coronary angiography was shorter in the tertiary hospital (within 1 vs. 2 days, p < 0.0001). Six-month mortality or readmission rates were similar (23.7% and 24.7% for tertiary and nontertiary care, respectively). After adjustment for comorbidity and disease severity, the relative risk of death or readmission for the tertiary hospital was 1.03 (95% CI 0.69 to 1.53) times that of the nontertiary hospitals. CONCLUSIONS: Selective use of coronary angiography and revascularization procedures may be as effective as less restricted use in the management of acute MI.
Aged↗
[Registries of morbimortality in cardiology: methods].
The effectiveness of diagnostic, preventive and therapeutic procedures, whose efficacy has been assessed in clinical trials, should be tested in a real treatment scenario. The procedures used in acute myocardial infarction (AMI) management can be evaluated by means of cohort studies that include all consecutive patients admitted to one or several hospitals. Such studies are called hospital registries. They are simpler to organize and cheaper than clinical trials. On the other hand, the AMI population-based registries allow the establishment of the incidence and mortality rates, as well as case-fatality as they include those patients who die before reaching hospital facilities. In both types of registries a set of variables on co-morbidity, age, sex, severity, and the utilization of procedures along with the course of the disease are systematically recorded in each patient using standard definitions to warrant the internal validity. In hospital registries, the external validity of the results will depend on whether the sample of hospitals represents the population where it was obtained. A good registry should include patients with a wide age range, allow the analysis of specific subgroups of patients such as non-Q wave or first AMI to allow for comparison with other registries. In addition, it should also permit a mid-term follow-up, respect ethical issues, receive appropriate funding and keep a multidisciplinary team involved in its design and development.
Cardiology↗
In-vitro antifungal susceptibility of clinical and environmental Fusarium spp. strains.
The MICs of amphotericin B, miconazole, ketoconazole, flucytosine, itraconazole and fluconazole for 19 isolates of Fusarium oxysporum, 16 Fusarium solani, seven Fusarium verticilliodes, four Fusarium proliferatum, four Fusarium dimerum, three Fusarium equiseti, and one each of the following species: Fusarium graminearum, Fusarium chlamydosporum, Fusarium semitectum, Fusarium avenaceum and Fusarium subglutinans were determined by a broth microdilution method. Thirty-eight of these isolates were of clinical origin and 20 from environmental sources. In general, Fusarium spp. strains showed resistance to all the antifungals tested. However, the most active agent was amphotericin B. Fluconazole and flucytosine were not active against any of the isolates tested. A correlation study of in-vitro testing with in-vivo outcome of amphotericin B of the cases of disseminated fusarium infections published is reported.
Antifungal Agents↗
Effects of incubation temperature, inoculum size, and time of reading on broth microdilution susceptibility test results for amphotericin B fgainst Fusarium.
In vitro antifungal susceptibility testing for filamentous fungi remains unstandardized and is unreliable for determining adequate therapy. A study was performed to evaluate the effect of inoculum size (10(2), 10(3), 10(4), and 10(5) conidia/ml), incubation time (48 and 72 h), and temperature (25, 30, and 35 degrees C) on MICs of amphotericin B for Fusarium spp. (20 strains). The inoculum size showed the clearest effect: when the inoculum was varied from 10(2) to 10(5) conidia/ml, the geometric mean MICs showed increases of between 10- and 19-fold in all the combined conditions of temperature and incubation time assayed. Time of incubation had less effect (increases of between two- and threefold in approximately half of the geometric mean MICs), and temperature especially had little effect (the increases were no higher than twofold). The effects of interaction between inoculum size and temperature on MICs were not statistically significant, while the combined effects of inoculum size and time of reading and of time of reading and temperature produced systematic variation in MICs.
Amphotericin B↗
Osteogenic sarcoma of the tongue. Case report and review of the literature.
A case of osteosarcoma of the tongue with lymph node metastasis is reported. The patient, 81 years old, underwent hemiglossectomy and neck dissection. The rarity of this tumor is emphasized and the treatment, differential diagnosis and etiology of osteosarcomas of the tongue are discussed. Osteogenic sarcoma of the extraskeletal soft tissues and organs is itself a rare event. To the best of our knowledge only three previous cases of primary osteogenic sarcoma of the tongue have been described. The aim of this report is to present a further case.
Aged↗
Perinatal alterations of thyroid hormones and behaviour in adult rats.
Several studies have shown the relevance of the neuroendocrinological system in the development and function of the nervous system. In order to observe the influence of thyroid hormones during development on the behaviour of adult rats we induced dysthyroid states during the perinatal period. Results indicate that some behaviours are more susceptible to the action of thyroid hormones than others. We observed that the thyroid hormone deficiency causes an increase of activity in animals in spite of a large period of rehabilitation. Thyroxine-treated rats showed an anxiogenic behavioural pattern in the elevated plus-maze, while animals rehabilitated from perinatal deficit of thyroid hormones showed an anxiolitic pattern. These findings suggest that an excess of thyroid hormones has less effect on behaviour than a deficiency of these hormones.
Aging↗