PubMed Health⌕ Search

Biomedical subjects

M Delgado Fernández

Publications and source records attributed to M Delgado Fernández.

16 recordsLinked to original sources
PubMed2002

[Nosocomial infection/colonization of the respiratory tract caused by Acinetobacter baumannii in an Internal Medicine ward].

BACKGROUND: To present the epidemiology of the outbreak and the description of patients with infection or colonization of the respiratory tract caused by A. baumannii in an Internal Medicine ward. METHODS: 20 consecutively patients hospitalized in the Internal Medicine ward were studied during 18 months with isolation of multiresistant A. baumanni in respiratory tract specimens with or without clinical signs of infection. RESULTS: Starting on an index case, that was a patient coming from other hospital with diagnosis of nosocomial Acinetobacter pneumonia, we detected 20 patients. The age of the patients ranged from 48 to 95 years, with a mean of 71.4 years. Eighty percent were males. The clinical features were similar: advanced age, with chronic diseases (35 percent diabetics, 45 percent with chronic lung diseases), and use of broad-spectrum antibiotics agents, fundamentally third generation cephalosporin (70 percent), clarithromycin (55 percent) and quinolones (30 percent). 75 percent of patients were in the same ward. Eight (40 percent) of the patients with chronic lung diseases were subjects with COPD, two with asthma and chronic glucocorticoids treatment, and one with a sleep apnea. In four cases the isolation was considered a colonization. The mean stay was 26.15 days, and the mortality 40 percent. CONCLUSIONS: The nosocomial infection caused by Acinetobacter baumannii is responsible of a high morbi-mortality between the patients hospitalized in an Internal Medicine ward, and produce an increase in length of stay. It is necessary a combination of control measures to prevent the transmission in the hospital and the outbreak of new multiresistant strains.

Acinetobacter Infections↗
PubMed2001

[Predictive factors for inappropriate hospital stays in an internal medicine department].

BACKGROUND: We aimed to know which factors are associated with inappropriate stays in an internal medicine department. SUBJECTS AND METHOD: We included 1,046 hospitalisations and evaluated the justification of the admission using the Appropriateness Evaluation Protocol. RESULTS: 176 (16.8%) stays were considered inappropriate. In a multiple regression model, variables defining an inappropriate stay were the number of days in hospital, diagnosis on admission and the weekly day. CONCLUSION: There are determining factors for inappropriate stays in an internal medicine department.

Age Factors↗
PubMed2001

[Factors associated with inappropriate hospitalization at an internal medicine department].

BACKGROUND: To determine the factors associated with inappropriate admissions in an Internal medicine department. SUBJECTS AND METHOD: We included 1,993 admissions. The justification for the admissions was evaluated using the Appropriateness Evalutation Protocol. RESULTS: 187 (9.4%) admissions were considered inappropriate. The likelihood of an inappropriate admission was higher as long as the patient was younger than 65 years of age (OR, 1.94; (95%) IC, 1.32-2.85) and the admission had been programmed from the outpatients clinic (OR, 10.58; (95%) IC, 2.79-40.1). Clinical diagnosis also influenced the inappropriateness of admissions. CONCLUSION: Age, diagnosis and source of patients determine inappropriate admissions in an internal medicine department.

Aged↗
PubMed2001

[Factors that influence the non prescription of beta-blockers in patients with acute myocardial infarction].

OBJECTIVE: To study the factors that influence the non prescription of beta-blockers in patients discharged with a diagnosis of acute myocardial infarction (AMI). METHOD: A retrospective study was done of all patients discharged from our Service in the year 1998, with a diagnosis of AMI. The variables considered were age, sex, diabetes mellitus, peripheral vascular disease, left ventricle dysfunction and COPD. RESULTS: 60 patients with AMI were included in the study, 18 of whom (30%) were discharged without beta-blockers. The average age of these patients was 77 years, while the average age of those discharged with these pharmaceutical agents was 60 years (p < 0.0001). Likewise, left ventricle dysfunction (p < 0.031) and female gender (p < 0.016), also negatively influenced the use of these drugs. It was observed with multivariable regression analysis that age was the main predictor for the use of beta-blockers (p < 0.0001). CONCLUSION: Age is the main factor that influences the non prescription of beta-blockers in patients with AMI in our Service. In spite of the potential adverse effects of the drugs in the advanced age population, the data so far obtained demonstrates a clear benefit in the subgroups at risk (advanced age, heart failure,...). Therefore it's use should be extended to this group of population as long as there are no absolute contraindications.

Adrenergic beta-Antagonists↗
PubMed1999

[What do the internal medicine residents of Anadalusia think of their specialty? Survey results].

BACKGROUND: To know the opinion of andalusian Internal Medicine (IM) residents about different subjects of their specialty, and their biomedical investigation activities. PATIENTS AND METHODS: A questionnaire with codified answers, facilitated to 64 IM residents of Andalusia. RESULTS: 69% of residents referred that IM was the specialty they wished to adhere at first choice. A 61% of residents would advice choosing IM as specialty to physicians with the exams for becoming a resident just passed. Best merit of IM for 89% of people was the global sight of the patient, and worst one for 37.5% was its tendency to fragmentation. 47% of residents consider that the role of the specialty will grow in the future. CONCLUSIONS: Our questionnaire reflects some of the contradictions that IM as a specialty is living, and probably show the rely of future internists to some future propositions about the specialty.

Adult↗
PubMed1997

[The clinical and evolutional characteristics of visceral leishmaniasis in patients with HIV infection].

OBJECTIVE: To analyze the clinical features, yield of the diagnostic techniques, and therapeutic response of HIV-associated visceral leishmaniasis (VL), and compare the initial episodes to the relapses. METHODS: Forty-one episodes of leishmaniasis visceral, diagnosed in 31 HIV-positive patients between 1st February 1992 and 31st January 1996 were reviewed. RESULTS: The prevalence of VL in HIV-positive patients in our center was 4.2%. Fifty-eight percent of the patients had AIDS prior to the diagnosis of VL. Fever was more frequent in the initial episodes than in the relapses (90.3% versus 60%; p < 0.05; OR: 6.2; IC 95%: 0.8-51.5), splenomegaly was more frequent in the relapses (100% versus 71%; p = 0.05). The diagnostic delay was longer in the initial episodes (27.2 +/- 22.7 versus 5 +/- 4.8 days; p < 0.05). The diagnostic yield of bone marrow biopsy was 82.1%, of liver biopsy 72.7% and of splenic fine-needle aspiration 87.5%. The indirect immunofluorescence test for Leishmania antibodies was positive in 5.9% of cases. Therapeutic failure occurred in 47.6% of patients treated with antimonials and 3.3% of patients treated with amphotericin B. Those patients who received secondary prophylaxis had less relapses than those who did not (17.6% versus 66.7%; p < 0.05; OR: 0.11; IC 95%: 0.01-1.28). Of the 31 patients, twenty-six (83.8%) died, and in none of them was the cause of the death directly related to LV. CONCLUSION: HIV-associated VL manifests clinically in a similar fashion to the immunocompetent's disease. It appears in advanced immunosuppression phases, behaving like other AIDS-defining illnesses. In spite of a good therapeutic response the relapse rate is high.

AIDS-Related Opportunistic Infections↗