Biomedical subjects

Jose Muñoz

Publications and source records attributed to Jose Muñoz.

3 recordsLinked to original sources

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↗

PubMed2004

Segmentation of vessels from mammograms using a deformable model.

Vessel extraction is a fundamental step in certain medical imaging applications such as angiograms. Different methods are available to segment vessels in medical images, but they are not fully automated (initial vessel points are required) or they are very sensitive to noise in the image. Unfortunately, the presence of noise, the variability of the background, and the low and varying contrast of vessels in many imaging modalities such as mammograms, makes it quite difficult to obtain reliable fully automatic or even semi-automatic vessel detection procedures. In this paper a fully automatic algorithm for the extraction of vessels in noisy medical images is presented and validated for mammograms. The main issue in this research is the negative influence of noise on segmentation algorithms. A two-stage procedure was designed for noise reduction. First, a global approach phase including edge detection and thresholding is applied. Then, the local approach phase performs vessel segmentation using a deformable model with a new energy term that reduces the noise still remaining in the image from the first stage. Experimental results on mammograms show that this method has an excellent performance level in terms of accuracy, sensitivity, and specificity. The computation time also makes it suitable for real-time applications within a clinical environment.

Algorithms↗

PubMed2004

Outcome predictors of pneumonia in elderly patients: importance of functional assessment.

OBJECTIVES: To evaluate the outcome of elderly patients with community-acquired pneumonia (CAP) seen at an acute-care hospital, analyzing the importance of CAP severity, functional status, comorbidity, and frailty. DESIGN: Prospective observational study. SETTING: Emergency department and geriatric medical day hospital of a university teaching hospital. PARTICIPANTS: Ninety-nine patients aged 65 and older seen for CAP over a 6-month recruitment period. MEASUREMENTS: Clinical data were used to calculate Pneumonia Severity Index (PSI), Barthel Index (BI), Charlson Comorbidity Index, and Hospital Admission Risk Profile (HARP). Patients were then assessed 15 days later to determine functional decline and 30 days and 18 months later for mortality and readmission. Multiple logistic regression was used to analyze outcomes. RESULTS: Functional decline was observed in 23% of the 93 survivors. Within the 30-day period, case-fatality rate was 6% and readmission rate 11%; 18-month rates were 24% and 59%, respectively. Higher BI was a protective factor for 30-day and 18-month mortality (odds ratio (OR)=0.96, 95% confidence interval (CI)=0.94-0.98 and OR=0.97, 95% CI=0.95-0.99, respectively; P<.01), and PSI was the only predictor for functional decline (OR=1.03, 95% CI=1.01-1.05; P=.01). Indices did not predict readmission. Analyses were repeated for the 74 inpatients and indicated similar results except for 18-month mortality, which HARP predicted (OR=1.73; 95% CI=1.16-2.57; P<.01). CONCLUSION: Functional status was an independent predictor for short- and long-term mortality in hospitalized patients whereas CAP severity predicted functional decline. Severity indices for CAP should possibly thus be adjusted in the elderly population, taking functional status assessment into account.

Activities of Daily Living↗