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Biomedical subjects

L Sáez

Publications and source records attributed to L Sáez.

At least 19 recordsLinked to original sources
PubMed1998

[Compliance, tolerance and effectiveness of a short chemoprophylaxis regimen for the treatment of tuberculosis].

OBJECTIVE: To evaluate compliance, side effects and the efficacy of a short course of chemoprophylaxis for tuberculosis with isoniazid plus rifampin during 3 months, compared with the classic course of isoniazid for 9 months. PATIENTS AND METHODS: Prospective, comparative, randomized and open study of patients with the suitable criteria for chemoprophylaxis, in accordance with the guidelines of the Centers for Disease Control of 1990. Patients were divided into 2 groups: the group of isoniazid plus rifampin, received isoniazid (300 mg per day) plus rifampin (600 mg per day) for 3 months, and the group of isoniazid, that received isoniazid at a dose of 300 mg per day for 9 months. RESULTS: 238 patients were included, of which 42 refused chemoprophylaxis. Of the remaining 196 patients, 98 were included in each group. Both groups were comparable at base level. The side effects, neither light nor severe showed significant differences. The appearance of adverse effects obliged the suspension of treatment in 7 patients in group isoniazid and of 9 patients in group isoniazid plus rifampin. Three patients in group isoniazid plus rifampin and 11 in group isoniazid stopped treatment (OR 4.14, 95% CI 1.02-19.45; p = 0.04). Efficacy was comparable in the two groups; only one case of tuberculosis was detected in a patient who gave up chemoprophylaxis at day 30. CONCLUSIONS: Tolerance in group isoniazid plus rifampin compared with group I was similar. Compliance was better in the short-term group with a lower percentage of abandonment. On comparing, both groups have shown similar efficacy in preventing the appearance of tuberculosis.

Adult↗
PubMed1997

[Estimation of surgical wound infection rates using a post-hospital surveillance program].

BACKGROUND: The decrease in the time spent in hospital of patients who have undergone surgery lessens wound observation time, and thus could underestimate the true rates of surgical wound infection (SWI). The aim of this study was to assess the use of a programme to detect SWI, by carrying out a control 30 days after patients have been discharged from hospital. PATIENTS AND METHODS: A study of a prospective cohort of 2,015 patients who were operated in 6 surgical services at a general hospital, was carried out to detect the incidence of SWI. The control at one month after discharge from hospital was done through a telephone survey using a specific questionnaire. RESULTS: SWI incidence was observed in 134 patients (6.7%), 38% of which were detected on the month after discharge from hospital. In the postoperatory control the major SWI rates were detected in the clean procedures and in the clean-contaminated procedures with 46% and 37%, respectively. The telephone interview enabled contact with 72.3% of the patients intervened. CONCLUSIONS: The post-discharge control of patients who have undergone surgery enabled the detection of more than a third of SWI cases. The telephone interview system has been effective in our study as a postdischarge method of the localization of patients.

Adolescent↗
PubMed1997

Brucellar osteomyelitis involving prosthetic extra-articular hardware.

We report the case of a patient with Brucella melitensis osteomyelitis involving non-joint prosthetic implant of the femur. This is the first case published of osteomyelitis by Brucella sp. in a patient with prosthetic implant in bone and the second one with both intra- or extra-articular prosthetic bone implant. Brucella melitensis is a rare organism which causes osteomyelitis in patients with prosthetic hardware, and should be added to the list of suspected organisms responsible for this disease, especially in endemic areas of brucellosis.

Brucella melitensis↗
PubMed1996

Treatment of human brucellosis with netilmicin and doxycycline.

We conducted a prospective, noncomparative, multicenter study to assess the safety and efficacy of doxycycline and netilmicin in the treatment of human brucellosis. The study included 64 patients who had acute brucellosis without endocarditis or neurobrucellosis. The treatment schedule consisted of the administration of 100 mg of doxycycline (or 5 mg/[kg.d] if body weight < or = 40 kg) twice a day orally for 45 days, plus 300 mg of netilmicin (6 mg/[kg.d] if body weight < or = 50 kg) intramuscularly once daily for 7 days. Therapeutic failure was noted in 5 patients (7.7%; 95% confidence interval [CI], 2.5%-17.1%), of whom 2 had spondylitis, 1 had sacroiliitis, and 1 had a splenic abscess that required splenectomy. Relapse was noted in eight patients (12.5%; 95% CI, 5.6%-23.2%). When relapse was considered in combination with initial lack of efficacy, 13 patients (21.9%; 95% CI, 12.3%-33.9%) failed to respond to therapy. Fifteen patients (23%; 95% CI, 13.5%-35.2%) had adverse effects, and one patient (1.5%) had a treatment-limiting adverse effect. Combination therapy with netilmicin/doxycycline may be effective in treating acute brucellosis. However, prospective controlled trials must confirm these results.

Acute Disease↗
PubMed1995

Doxycycline-rifampin versus doxycycline-streptomycin in treatment of human brucellosis due to Brucella melitensis. The GECMEI Group. Grupo de Estudio de Castilla-la Mancha de Enfermedades Infecciosas.

Brucellosis is a common zoonosis in many parts of the world; the best regimen for the treatment of brucellosis has not been clearly determined. We have carried out a multicenter, open, controlled trial in five general hospitals in Spain to compare the efficacy and safety of doxycycline and rifampin (DR) versus doxycycline and streptomycin (DS) for the treatment of human brucellosis. The study included 194 ambulatory or hospitalized patients with acute brucellosis, without endocarditis or neurobrucellosis. The diagnostic criterion was isolation of Brucella species from blood or other tissues (n = 120) or a standard tube agglutination titer of 1/160 or more for anti-Brucella antibodies with compatible clinical findings (n = 74). Patients were randomly assigned to receive either 100 mg of doxycycline twice daily plus rifampin, 900 mg/day, in a single morning dose for 45 days (DR group) or the same dose of doxycycline for 45 days plus streptomycin, 1 g/day, intramuscularly for 14 days (DS group). A lack of therapeutic efficacy developed in 8 of the 100 patients in the DR group (8%) and in 2 of the 94 patients in the DS group (2%)(P = 0.10). Relapses occurred in 16 of the 100 patients in the DR group (16%) but in only 5 of the 94 patients in the DS group (5.3%) (P = 0.02). When relapse was considered in combination with initial lack of efficacy, 26 patients in the DR group (24%) and 7 patients in the DS group (7.45%) failed to respond to therapy (P = 0.0016). In general, therapy was well tolerated and only four patients (4%) in the DR group and two (2%) in the DS group had episodes of adverse effects necessitating discontinuation of treatment (P> 0.2). We conclude that a doxycycline-and-rifampin regimen is less effective than the doxycycline-and-streptomycin regimen in patients with acute brucellosis.

Adolescent↗
PubMed1995

[Decrease of labor absenteeism associated with hormone replacement therapy in postmenopausal women].

Absenteeism affects efficiency and costs of health care. Most of health workers are middle age women, whose climacteric symptoms may reduce their work capacity working at a public hospital in Santiago during 1992. Fifty-eight percent were postmenopausal and 34.8% of these were receiving hormone replacement therapy. Global absenteeism rate was 17.1 days/year. These figures were 14.8 days/year for premenopausal and 17.8 days/year for postmenopausal women (NS). Among the latter, those women receiving hormone replacement therapy had a significantly lower absenteeism rate (9.4 days/year compared to 20.4 days/year among those not receiving hormones). Osteoarticular diseases were responsible for 44.3% and psychiatric diseases for 18.1% of sick leaves. No differences in absenteeism were observed between different professional levels. We conclude that hormone replacement therapy is associated with a better working capacity in postmenopausal women.

Absenteeism↗
PubMed1994

[Meta-analysis of the efficacy of the combination of +rifampicin and doxycycline in the treatment of human brucellosis].

BACKGROUND: The aim of this study was to determine whether a conclusion could be obtained through meta-analysis of the published trials on the relative efficacy of rifampicin and doxycycline versus streptomycin and doxycycline or another tetracycline (SD). METHODS: The comparative and randomized trials identified by a search in the reference data base MEDLINE from 1967 to 1992 and through manual review of the articles cited in these studies or other reviews were included. The evaluation of quality was performed by a standardized scale. The differences in efficacy were expressed as odds ratio and the results were contrasted by the Mantel-Haenszel method. Heterogenicity was graphically analyzed by the Woolf method with an adjustment being made for small subgroups. The confidence intervals were calculated for each trial and for the combined data by the Cornfield method. RESULTS: Six trials including 581 patients of whom 544 were considered evaluable were analyzed. In the RD treatment group 261 (242 valid) patients were included with 268 (253 valid) being included in the SD group. Five cases of initial therapeutic failure were observed in each group without significant differences. The secondary effects described were very variable. Nonetheless no secondary effects obliging discontinuation of treatment were presented in the RD group with only one in the SD group with no differences between the two groups. Recurrences were presented in 5% and 39% in the RD group and in 0 and 17% in the SD group. In total 37 (16%) in the former group and 13 (5%) in the latter group. The Mantel-Haenszel odds ratio with respect to recurrence was 3.81 (CI 95%, 1.82-8.17; p = 0.00009). The total number of cures was 196 (81%) in the RD group and 232 (92%) in the SD group (Mantel-Haenszel odds ratio 0.36; CI 95%, 1.19-0.64; p = 0.0004). The inclusion of the quality index of the trials did not modify the statistical significance achieved. CONCLUSIONS: In human brucellosis the treatment of rifampicin and doxycycline presents a greater number of recurrence and lower number of cure than the classical treatment with streptomycin and tetracycline drugs.

Brucellosis↗
PubMed1993

[Risk of tuberculosis in parenteral drug addicts with human immunodeficiency virus seropositivity. A cohort study in detoxication communities].

BACKGROUND: The aim of this study was to determine the risk of active tuberculosis in intravenous drug addict (IVDA) patients seropositive and seronegative for the HIV. METHODS: A retrospective study of a cohort of IVDA males in 2 drug addict detoxication communities was carried out. Patients with tuberculosis, under treatment or chemoprophylaxis for tuberculosis and those with a stay of less than 3 months were excluded. Patients included underwent a serologic study to detect antibodies versus HIV and a Mantoux test with 2 U. PPDRT23. Subjects who were HIV+ with a Mantoux test < 5 mm were given a delayed cutaneous sensitivity test with 7 antigens. The incidence index of tuberculosis was studied. Logistic regression analysis was performed to evaluate the relative risk of tuberculosis in HIV+ controlled by other variables (having been in prison, previous liver disease, country of origin, age, length of IVDA and length of follow up). RESULTS: Of the 198 patients admitted 132 were included. Forty-seven were HIV+ and 85 HIV-. Fourteen of the former (30%) and 44 of the latter (51%) had a positive reaction to the Mantoux test (OR 0.4; confidence interval 95% 0.18-0.92; p < 0.05). Eight seropositive (17%) patients with a negative Mantoux test presented anergia to the delayed cutaneous sensitivity tests. After a mean follow up of 12.0 +/- 9.0 months, 4 patients out of the 47 HIV+ (8.5% or 6.93 cases/100 individuals/year; CI 95% 0.13-13.72) presented tuberculosis versus none of the 85 HIV- (p < 0.05) patients. Of the 4 patients diagnosed of tuberculosis, the initial reaction to the Mantoux test was negative in 2 (one pulmonary and the other milliar tuberculosis). Two of the 4 patients diagnosed of tuberculosis died. CONCLUSIONS: The risk of active tuberculosis is specially high in HIV seropositive intravenous drug addicts. The response to the Mantoux test has little sensitivity for demonstration of tuberculous infection in HIV seropositive patients.

Adolescent↗
PubMed1992

[Clinical heterogeneity of the autistic syndrome: a study of 60 families].

Sixty families ascertained through a single proband, has helped to better define infantile autism as a heterogeneous group of disorders. Forty four patients showed a characteristic facio- auricular dysplasia. Twenty four of these, showed increased pyruvate and lactate and laboratory findings of metabolic acidosis i.e., anion gap above 18 mEq/L or serum bicarbonate below 21 mEq/L but only nine of these probands demonstrated reduction of plasma bicarbonate below 18 mEq/lt. Plasma amino acids in 17 probands and matched controls showed increased taurine with the rest of amino acids significantly (p less than 0.05) below the control level. Glutamate and aspartate were also significantly elevated (p less than 0.05; Student t-test). Segregation analysis in thirty four of these families which linked through at least one ancestral family name, suggested autosomal recessive inheritance (p = 0.20). Three out of eight probands who received megadoses of pyridoxine (Vitamin B6), subjectively gained in language abilities, affectivity and response to behavior modification therapy. Five autistic patients proved to have clinically defined syndromes: two with the Martin-Bell syndrome, and three girls affected respectively with the Rett syndrome, phenylketonuria and dicarboxylic aciduria.

Acidosis↗
PubMed1984

Fish liver protein synthesis during cold acclimatization: seasonal changes of the ultrastructure of the carp hepatocyte.

A cell-free system, active in protein synthesis, was constructed using ribosomes and supernatant factors isolated from the livers of winter-acclimatized carps. Upon seasonal adaptation, the hepatocytes of these fishes exhibited distinctive morphological features that were not sex dependent. The cytoarchitecture of the liver cell from summer carps is consistent with the cellular arrangements found when the rate of gene expression is high. During winter, several morphological features reveal that macromolecular synthetic activity may be clearly diminished.

Acclimatization↗
PubMed1984

Effects of insulin on the fine structure of hepatocytes from winter-acclimatized carps: studies on protein synthesis.

Male and female winter-acclimatized carps were injected with insulin. This treatment resulted in a sharp decrease in the liver glycogen content. Although an increase in the ribosomal RNA level was also observed, a cell-free system obtained from the hormone-treated fish exhibited less amino acid incorporation activity as compared to the control fish. However, polysomes from insulin-treated fish exhibited a higher amino acid incorporating activity when a soluble fraction of untreated winter carps was used. Insulin induced a profound change in the cytoarchitecture of the winter carp hepatocyte. The cytoplasm and nuclei showed all the features of the summer carp liver cell. The nucleolar components were totally intermingled suggesting a high rate of gene expression as in the case of the summer-acclimatized fish.

Acclimatization↗