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Biomedical subjects

L Force

Publications and source records attributed to L Force.

At least 19 recordsLinked to original sources
PubMed2006

Sporadic and epidemic community legionellosis: two faces of the same illness.

The present study compares the risk factors, presentation and outcome of community-acquired Legionella pneumophila pneumonia in 138 sporadic-case patients (1994-2004) and 113 outbreak-case patients (2002) treated in two hospitals in Catalonia (Spain) since urinary antigen assays were adopted. Univariate and multivariate analysis were performed to compare epidemiological and clinical features, blood chemistry values, radiological findings and outcome of sporadic and epidemic legionnaires' disease. Univariate analysis showed that male sex, chronic lung disease, HIV infection and immunosuppressive therapy prevailed in sporadic cases. Presentation with respiratory symptoms, confusion and blood chemistry alterations, such as hyponatraemia, aspartate aminotransferase and blood urea nitrogen elevation, and partial pressure of oxygen P(O)(2) <7.98 KPa (60 mmHg) were also more frequent in sporadic cases, while headache prevailed in outbreak cases. Sporadic cases had a greater delay in treatment, were more severe and had a worse outcome than epidemic cases. Multivariate analysis showed significant differences in sex, chronic lung disease, HIV infection and headache. The clinical and outcome differences between the two groups may be explained by the detection of milder forms of legionnaires' disease, the earlier treatment and the lower severity of underlying disease in the outbreak cases.

Adult↗
PubMed2001

Failure of a short-term prednisone regimen to prevent nevirapine-associated rash: a double-blind placebo-controlled trial: the GESIDA 09/99 study.

OBJECTIVES: Rash is the most frequent adverse event associated with nevirapine. The use of prednisone has been controversial in this setting. A double-blind placebo-controlled study was performed to evaluate its efficacy in nevirapine-induced rash prevention. DESIGN: Multicentered, randomized, double-blind, placebo-controlled clinical trial with prednisone (30 mg/day x 2 weeks). INCLUSION CRITERIA: HIV-1 infection; CD4 count >200 cells/mm3; plasma viral load (PVL) <5 log10 copies/ml; nevirapine (200 mg/day x 2 weeks, followed by 200 mg twice daily) plus stavudine and didanosine. Clinical follow-up was performed at 15, 30, and 60 days and thereafter every 2 months. RESULTS: In all, 75 evaluable patients were enrolled (39 prednisone/36 placebo). Median baseline CD4 + cell count was 390 cells/mm3 and PVL, 20,200 copies/ml. Overall, nine cases of rash (12.5%) were detected, seven (18%) in the prednisone group and two (5.5%) in the placebo group (odds ratio [OR], 3.85; 95% confidence interval [CI], 0.65-29.3; p =.11). Incidence of moderate-to-severe rashes leading to nevirapine withdrawal was 13.5% (5 of 37) in the prednisone group and 3% (1 of 35) in the placebo group ( p =.2). Median time to rash in both groups was 16 days. Adverse events that motivated withdrawal of therapy appeared in 6 patients from the prednisone group (15.4%) and 3 from the placebo group (8.3%) ( p =.3). CONCLUSION: Short-term prednisone administration does not prevent nevirapine rash, but might even increase its incidence.

Adult↗
PubMed1992

Evaluation of eight serological tests in the diagnosis of human echinococcosis and follow-up.

The ELISA with use of IgG, IgA, and IgE, latex agglutination, indirect hemagglutination (IHA), total IgE, the radioallergosorbent test (RAST), and immunoelectrophoresis (IEP) were carried out to determine the preoperative diagnosis of infection due to Echinococcus granulosus in 131 patients. Eighty-nine patients received follow-up care for 42 +/- 22 months (mean +/- SD); 72 were treated surgically and 17 with mebendazole only. We analyzed 5 +/- 2 serum samples per patient and analyzed each serum sample using the eight tests. IgG ELISA was the most sensitive (up to 94%) and specific (up to 99%) test for the majority of cyst locations in the patient. IEP was positive in only 73% of cases. The combination of IgG ELISA, IHA, and IgA ELISA allowed us to achieve a sensitivity of 81% in cases of pulmonary echinococcosis. IgE and IgA were both responsible for most nonspecific reactions, the former in patients with parasitic diseases other than echinococcosis and the latter in patients with cirrhosis of the liver and malignancies. IgG ELISA and IHA were the most adequate tests for postsurgical follow-up. In patients with favorable clinical outcome, the specific IgG level decreased early toward the end of the first year, although serological positivity could persist beyond 6 years. A rise of IgG level 2 or 3 years after treatment suggested persistent active infection. In patients with mebendazole-associated cure, only tests with total or specific IgE detection seemed to exhibit a strong association with decreasing levels or with negative results.

Adolescent↗
PubMed1991

[Acute pyelonephritis. Prospective analysis of 91 cases].

Ninety nine patients suffering of acute pyelonephritis are prospectively analyzed. Mean age was 39.8 +/- 18.2 (mean +/- DE), 72 of them were females and 19 were males. The most frequent clinical manifestations were fever and side pain in 97% of the cases and lower urinary syndrome in 78%. The duration of symptoms previous to the visit was 3.5 +/- 2.9 days. Bacteremia was confirmed in 99% of cases, it affected the oldest patients (p less than 0.001) and provoked the lasting of fever (p less than 0.05). E. coli was the most frequently isolated microorganism with an incidence of 91% in the isolated samples. Gentamicin was the initial treatment and the definitive treatment was prolonged to a total of 14 days. Fifteen percent of patients were classified after the evaluation as carriers of complicated pyelonephritis and had to undergo afterwards a urologic treatment. Follow up over a minimum of 6 weeks showed a treatment failure in 2% of cases and recurrency in 22%.

Acute Disease↗
PubMed1989

[Incidence of nosocomial infections. Comparison of 2 surveillance systems: clinical vs microbiological follow-up].

The effectiveness of a clinical and a microbiological follow-up systems for the detection of hospital-acquired infection (HI), both independently and simultaneously applied, were prospectively evaluated. The observed incidence rate was 11.4%. The clinical follow-up detected 81.3% of HI while microbiological follow-up detected 59.7%. This difference was statistically significant (p less than 0.001). It took 43 and 45 minutes to detect each instance of HI with the clinical and microbiological methods, respectively. Clinical methods are the most adequate to obtain maximal sensitivity in the overall surveillance of hospital-acquired infection, whereas microbiological follow-up may be useful for the detection of some types of HI such as bacteremia or urinary tract infection.

Cohort Studies↗
PubMed1989

Breakage and detachment of an Abrams needle in the pleural cavity during performance of a pleural biopsy.

This is the report of a case of breakage and detachment in the pleural cavity of the tip of a nearly new Abrams needle during performance of a pleural biopsy. We have not found any reference in the literature to similar accidents and do not know what later complications may be produced by the metal body in the pleural cavity. In this case, there have been no complications 12 months after the incident.

Aged↗
PubMed1988

Effects of high pressure on nervous conduction velocity in man.

The velocities of motor and sensory nervous conduction and of neuro-muscular transmission were measured in four subjects during a simulated dive at 4.6 MPa (46 bars). The results show an increase in motor distal latency in the ulnar nerve, especially during decompression, with reversibility of the effect on return to ambient conditions. The hypothesis of an interaction of dissolved gases with the membranes of ischaemic cells is proposed.

Adult↗