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Biomedical subjects

L Lorente

Publications and source records attributed to L Lorente.

At least 19 recordsLinked to original sources
PubMed2006

Nosocomial outbreak of Pseudomonas aeruginosa infections related to a flexible bronchoscope.

An outbreak of Pseudomonas aeruginosa infections affecting 17 patients was detected in the 27-bed intensive care unit (ICU) of a community hospital from 1 July to 30 September 2003. An ambidirectional cohort study was conducted to identify the risk factors for infection. Nosocomial infections were defined using the criteria of the Centers for Disease Control and Prevention. Random arbitrary polymorphic DNA-polymerase chain reaction was used for genotypic characterization. Logistic regression analyses demonstrated that case patients were more likely than non-cases to have had a longer stay in the ICU, and to have undergone mechanical ventilation and antimicrobial treatment. The multi-variate analysis identified recent bronchoscopy [risk ratio (RR) 3.8, 95% confidence interval (CI) 2.5-3.9] and exposure to an infected patient (RR 2.9, 95% CI 1.1-3.7) as independent risk factors. Molecular analysis showed that of the nine isolates available, four patients had a similar strain. The factor with the strongest influence on the risk of death was infection with P. aeruginosa (RR 2.1, 95% CI 1.0-2.4, P=0.04). A combined infection control strategy was implemented, including strict compliance with isolation precautions and recommendations for cleaning and disinfecting bronchoscopes, and a sharp reduction in the incidence of P. aeruginosa infection followed. It is thought that this outbreak was caused by patient-to-patient transmission and infection from a common source, i.e. the flexible bronchoscope.

Bronchoscopes↗
PubMed2001

Neuro-immune-endocrine functional system and vascular pathology.

A new interpretation of the response to injury by the nervous, immune and endocrine system is proposed, in order to integrate biochemical knowledge into the respective clinical areas. The discovery that the signaling molecules of the classical nervous, immune and endocrine systems, that is, the neurotransmitters, cytokines and hormones, respectively, are expressed and perceived by the three systems, has enabled us to establish a functional concept of these systems. The hypothetical integration of different pathological processes in a functional response made up by three phases, the immediate or nervous, intermediate or immune and late or endocrine ones, makes it possible to consider that all of them represent different forms of expression of a functional response whose meaning is always the same, that is, inflammation. If the functions that characterize each one of these three phases represent the activity of the nervous, immune and endocrine systems, the biochemical knowledge could be integrated into the functional meaning of each system.

Endocrine Glands↗
PubMed2001

Pneumonia in patients with severe burns : a classification according to the concept of the carrier state.

OBJECTIVE: To establish baseline values of pneumonia incidence and mortality and to distinguish primary endogenous from secondary endogenous and exogenous pneumonias in a homogeneous patient population with severe burns. DESIGN: Cohort study. SETTING: A six-bed burn ICU. PATIENTS: All patients of > or = 14 years admitted to the ICU between January 1995 and June 1996 with a total body surface area burn of > or = 20%. INTERVENTION: Collection of data on surveillance samples from throat and rectum on admission and twice weekly afterward, and pneumonias during the ICU stay. MEASUREMENTS AND RESULTS: Fifty-six patients fulfilled the criteria of the study. Mean age was 43 +/- 19.8 years; total body surface area burn, 41 +/- 18.2%; the area of full-thickness burn was 24 +/- 17.7%. Forty-one patients required mechanical ventilation. Twenty-seven patients (48%) experienced 37 episodes of pneumonia. Twenty-one pneumonias were of primary endogenous development, ie, caused by potential pathogens carried in the admission flora. There were 14 secondary endogenous and 2 exogenous infections caused by microorganisms acquired on the burn unit. Inhalation injury was identified in 26 patients. The pneumonia rate was two times higher in the subset of patients with inhalation injury compared with the group of patients without inhalation injury (p < 0.001). Overall mortality was 25%. CONCLUSIONS: This study shows that pneumonia in burn patients is mainly an endogenous problem. Interventions that prevent the development of endogenous infections deserve prospective evaluation in patients with severe burns.

Adolescent↗
PubMed1999

Hepatic cytochrome oxidase in rats with microsurgical cholestasis or portocaval shunt.

AIMS: portocaval shunt and extrahepatic cholestasis are experimental models of chronic hepatic insufficiency of different etiology and histological characteristics, and which probably also differ in the mechanism of impairment of oxidative metabolism. To test this hypothesis we measured hepatic cytochrome oxidase. METHODS: cytochrome oxidase was assayed with a histochemical technique in three groups of Wistar rats: A (n = 8) control; B (n = 8) microsurgical extrahepatic cholestasis; and C (n = 8) end-to-side portocaval shunt. RESULTS: cytochrome oxidase activity was lowest in group B, both in the left middle (p = 0.00019) and in the inferior caudate (p = 0.00014) hepatic lobes, and was highest in group C in both hepatic lobes, especially in the left middle lobe (p = 0.0029). CONCLUSION: the decrease in cytochrome oxidase activity in the liver of rats with extrahepatic cholestasis and the increase in animals subjected to portal flow deprivation demonstrate the different nature of the impairment in hepatic oxidative metabolism in these two pathological conditions.

Animals↗
PubMed1998

[Value of quantification of p24 antigen in plasma as a prognostic marker of survival in a cohort of 251 HIV-positive patients].

OBJECTIVE: To analyse plasma p24 antigen as a marker of survival in a cohort of HIV-infected patients whose time of seroconversion is unknown. DESIGN: Prospective cohort study. SETTING: AIDS Unit in a teaching hospital. PATIENTS: 251 patients were studied, most on antiretroviral therapy. Mean initial CD4 cell counts were 376 x 106/ 1 (range: 0.8-1350). 51 cases had been diagnosed previously with AIDS. METHODS: Analysis of survival, according to initial plasma p24 antigen was performed by Kaplan-Meier test. Relative risks were calculated by Cox's proportional hazards model. RESULTS: During a follow-up period of 24 months, 46 patients died. Relative risk (RR) of death related to the group with p24 antigen = < 40 pg/ml was 3.32 when p24 antigen > 40 pg/ml (p = 0.0001). CD4+ cell levels adjusting, the result was 2.47 (CI 95% 1.37-4.46) (p = 0.0027). CONCLUSIONS: Plasma levels of p24 antigen is useful as a marker of the risk of death and it behaves as a independent prognostic marker in our patients. P24 antigen = < 40 pg/ml is associated with a better prognosis.

Biomarkers↗
PubMed1997

Changes of cytochrome oxidase activity in rat suprachiasmatic nucleus.

This paper evaluates the changes of cytochrome oxidase (CO) activity that take place in the suprachiasmatic nucleus (SCN) during the light-dark cycle. CO is a mitochondrial energy-generating enzyme used as a marker of neural oxidative metabolism. We measured CO activity using quantitative histochemistry calibrated with brain tissue standards and a computerized analysis image system. The results indicate that the CO enzyme activity changes on the basis of a circadian pattern, with the higher levels during the light phase (P < 0.0001). These changes are detected over a period of hours, in accordance with other studies on the possible short-term regulation of CO activity in the nervous system. It is, therefore, possible to apply this methodology to the study of the SCN and other brain areas which show functional rhythmicity.

Animals↗
PubMed1997

Portacaval shunt control animals: physiological consequences derived from the sham operation.

The portacaval shunt in the rat is a frequently used experimental model of portosystemic encephalopathy. Among other consequences of this surgical preparation is an important decrease in hepatic and testicular volume. Different sham-operation methods including a laparotomy were used as controls in each case. Given that the liver volume varies greatly in comparison to body weight in the sham-operated animals, this paper aims to evaluate the possible consequences of the sham operation. It concludes that control animals without manipulation, in addition to the respective controls of portacaval shunt, should be used in every case.

Analysis of Variance↗
PubMed1997

[Microbiological and auditory analysis before and after topical treatment of chronic suppurative otitis media without cholesteatoma].

The AA. present a study microbiologic and auditive as well about chronic, suppurative otitis media non cholesteatomatous, before and after topical treatment. They contemplate 178 samples of chronic discharging ears which were treated with gentamycin 0.3 %, instillation 5 drops every 8 hours, during 10 days. Twelve days later were newly assessed both the otorrhea and the cochleovestibular picture. Germs most frequently detected: Gram-negative 61.6 %, Gram-positive 19.8 %, associated flora 6.4 % and mycosis 2.2 %, among other. Clinic healing accounted for 97.29 % and not significative differences scored pre--and post-treatment.

Administration, Topical↗