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Joaquim Gascón

Publications and source records attributed to Joaquim Gascón.

11 recordsLinked to original sources
PubMed2006

Epidemiology, etiology and pathophysiology of traveler's diarrhea.

Traveler's diarrhea (TD) is the most frequent health problem in travelers to developing countries. Several personal and environmental risk factors are at the basis of TD acquisition and are discussed in this paper. TD is caused by a wide range of infectious organisms, ETEC and EAEC bacteria strains being the main enteropathogens incriminated in TD. Other causative bacteria are: Shigella spp., Campylobacter spp., Vibrio spp., Aeromonas spp., Salmonella spp., and Plesiomonas spp. Parasite species are also included: Cyclospora cayetanensis, Giardia lamblia, Cryptosporidium, Entamoeba histolytica, as well as viruses: rotavirus, adenovirus, Norwalk virus. Due to the great diversity of pathogens incriminated, several pathophysiological mechanisms have been described and some of them are still poorly understood. The clinical symptoms present are also quite variable, although inflammatory and non-inflammatory diarrhea have been established as a classical and basic classification of diarrhea.

Bacteria↗
PubMed2006

[How much primaquine is needed to eradicate Plasmodium vivax hypnozoites?].

INTRODUCTION: Primaquine is now the only drug available to eradicate Plasmodium vivax malaria. The optimal dose of primaquine to prevent relapses of P. vivax remains under discussion. CLINICAL CASES: We describe three cases of P. vivax malaria from different geographical areas, in which a tolerance to standard doses of primaquine and, in some cases, to much higher doses has been observed. COMMENTS: P. vivax tolerance to primaquine is an emerging problem in daily practice. Reassessment of the primaquine dose required to eradicate P. vivax intrahepatic hypnozoites is needed.

Adult↗
PubMed2006

Failure of standard treatment with praziquantel in two returned travelers with Schistosoma haematobium infection.

A single 40 mg/kg dose of praziquantel (PZQ) continues to be the standard treatment for schistosomiasis caused by S. mansoni and S. haematobium in all clinical settings. Experimental development of drug resistance and the recent isolation of S. mansoni strains with a natural tolerance to high doses of PZQ have raised concerns over the adequacy of such a dose. We describe two Spanish travelers with genitourinary schistosomiasis caused by S. haematobium in whom repeated standard treatment failed to clear the infection.

Adult↗
PubMed2006

Dissemination of Salmonella enterica serotype agona and multidrug-resistant Salmonella enterica serotype typhimurium in Cuba.

The molecular epidemiology, antimicrobial susceptibility, and mechanisms of resistance of 34 Salmonella spp. strains causing acute gastroenteritis, isolated from different provinces in Cuba, were determined. Sixty-four percent of the strains showed multiresistance. Salmonella typhimurium was the most frequent with 15 strains (44%), 13 of which belonged to phagotype 104 and presented similar genetic profiles of pulsed field gel electrophoresis. High levels of resistance to tetracycline (53%), spectinomycin (50%), ampicillin (44%), and chloramphenicol (41%) were found. Resistance to tetracycline was associated with the tet G and tet A genes. Resistance to ampicillin was caused by the presence of beta-lactamases, mainly the CARB type. The floR gene was the main mechanism of resistance to chloramphenicol. Our results showed an antimicrobial susceptible clone of Salmonella enterica serotype Agona in two separate regions. This is the first report of the widespread dissemination of a multiresistant clone of S. enterica serotype Typhimurium definitive phage type 104 in Cuba.

Anti-Bacterial Agents↗
PubMed2005

[Molecular epidemiological surveillance of markers for antimalarial drugs in Plasmodium falciparum isolates imported to Barcelona, Spain].

BACKGROUND AND OBJECTIVE: There have been described compelling correlations between mutations in some Plasmodium falciparum genes and resistance to antimalarial drugs. To apply molecular techniques in the mechanisms of epidemiological surveillance in the Hospital Clínic of Barcelona and to map potential levels of resistance, we investigated the presence of mutations in the relevant codons of genes associated with resistance in P. falciparum isolates imported by travellers. PATIENTS AND METHOD: The genes pfctr, pfmdr1, dhfr, dhps and cytochrome b were analyzed by PCR and enzymatic restriction in P. falciparum isolates from 53 persons attending the Tropical Medicine Department after a trip to a malaria endemic area. RESULTS: 63% of patients were infected with a P. falciparum isolate with the K76T mutation in pfctr. Tyr86 in pfmdr1 was found in 54% of the isolates. Mutations in codons 51, 59 and 108 in dhfr were found in 33%, 49% and 44% of the isolates, respectively. Mutations in codons 436, 437 and 540 in dhps were found in 35%, 35% and 8.5% of the isolates. 30% of travellers were infected by parasites displaying 3 or more mutations in any of the codons of dhps and dhfr. None of the patients had a mutation in the Tyr268 codon of the cytochrome B gene. CONCLUSIONS: The high prevalence of mutations in the imported isolates suggests a fast development and expansion of resistance against most of the antimalarial drugs commonly used. The concurrence of more than one mutation in different loci suggests the expansion of multiple resistances.

Animals↗
PubMed2005

[Imported malaria from Senegal: about 17 cases in year 2000].

BACKGROUND AND OBJECTIVE: Senegal is increasingly becoming a touristic target for many people. In 2000, there was a greater number of cases of malaria in patients from this country. Our objective was to analyze such increase, to describe the characteristics of these patients and to identify the reasons for it. PATIENTS AND METHOD: From 1999 to 2002 we prospectively collected the clinical and epidemiological data of all consecutive malaria cases seen in the Unit of Tropical Medicine of the Hospital Clinic (Barcelona, Spain). RESULTS: We attended 276 patients, 74 of them during 2000; of them, 17 had travelled to Senegal and Gambia. Their mean age was 36.58 (6.9) years and 12% were women. 59% patients were Spaniards, 35% were native of Senegal and 6% of Gambia. Reason of travel was tourism in 9 cases (53%) and a visit to the family in 7 cases (41%). Mean duration of the visit was 31 (20.6) days and only 17.6% patients did a right prophylaxis. Plasmodium falciparum was the commonest species (88%). The number of patients with malaria who had visited Senegal ranged from 6.6% in 1996 to 20% in 2000 to 6.3% in 2002 (p<0.05). CONCLUSIONS: There was an unexpected increase of malaria imported from Senegal in 2000 in our Unit. Changes in both the dynamics of malaria transmission and tourism offers may account for an unsuspected increase of malaria cases.

Adult↗
PubMed2003

[Ciguatera poisoning in Spanish travellers].

BACKGROUND AND OBJECTIVE: Ciguatera poisoning appears after ingestion of contaminated fish from tropical coral reefs. Due to the diversity of clinical symptoms and the absence of a specific test in humans, the diagnosis is often difficult. PATIENTS AND METHOD: A retrospective study of 10 patients consulting for a clinical and epidemiological picture compatible with ciguatera poisoning after a trip to tropical countries between 1993 and 2000. RESULTS: Most infections but one were acquired in the Caribbean area and there were 8 females. Clinical manifestations started within the first 24 hours after fish ingestion. Chief symptoms were diarrhea and nausea, followed by neurological symptoms, mainly limbs paresthesias that persisted for several weeks. CONCLUSIONS: The severity of clinical symptoms was variable and not related to age or initial symptoms. Ciguatera poisoning has to be considered in the diagnosis of acute gastroenteritis affecting travellers to tropical areas.

Adolescent↗
PubMed2001

Susceptibility patterns of enteroaggregative Escherichia coli associated with traveller's diarrhoea: emergence of quinolone resistance.

Enteroaggregative Escherichia coli (EAggEC) isolates were identified as a cause of traveller's diarrhoea in 50 (9%) of 517 patients and their antimicrobial susceptibility was determined. Molecular epidemiological characterisation and investigation of the mechanisms of acquisition of quinolone resistance among nalidixic acid-resistant EAggEC strains was performed. Seventeen (34%) of 50 patients needed antimicrobial therapy, because of persistence of symptoms in nine cases and the severity of symptoms in eight cases. Ampicillin and tetracycline resistance was high, whereas chloramphenicol and co-trimoxazole showed moderate activity and amoxicillin plus clavulanic acid, nalidixic acid and ciprofloxacin showed very good activity. Resistance to nalidixic acid was demonstrated in three isolates, two from patients who had travelled to India. In all three strains the resistance was linked to mutations in the gyrA gene alone or in both gyrA and parC genes. Although ciprofloxacin shows excellent in-vitro activity and could be useful in the treatment of traveller's diarrhoea in patients travelling abroad, it may not be useful in patients who have journeyed to India or to Mexico.

Anti-Bacterial Agents↗