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Biomedical subjects

M Fernández-Guerrero

Publications and source records attributed to M Fernández-Guerrero.

11 recordsLinked to original sources
PubMed2003

Inflammatory pseudotumor of the spleen in a patient with human immunodeficiency virus infection: a case report and review of the literature.

Inflammatory pseudotumor of the spleen (IPS) is a rarely described benign tumoral lesion of unknown etiology and pathogenesis. Diagnosis is complex as clinical manifestations and imaging features are indistinguishable from lymphoproliferative disorders and other malignancies of the spleen. Human immunodeficiency virus (HIV) infection is often combined with several malignancies including non-Hodgkin's lymphoma and Kaposi's sarcoma. However, no HIV infection-associated IPS has been reported so far. We report and discuss a case of IPS in an HIV-infected woman who presented with abdominal pain and multiple lesions in the spleen.

Adult↗
PubMed1997

Circulating immune complexes from HIV-1+ patients induces apoptosis on normal lymphocytes.

Isolated immune complexes from sera of 49 out of 67 human immunodeficiency virus-1-positive (HIV-1+) patients (CIC-HIV+), composed of anti-HIV-HIV-Ag, could induce apoptosis on normal phytohaemagglutinin (PHA)-activated lymphocytes. DNA degradation was detected by propidium iodide staining. This activity is directed against CD4+ lymphocytes as demonstrated by double binding of CIC-HIV+ and anti-CD4 on apoptosis cells. Expression of Fas antigen is prior to apoptotic phenomena. CIC-HIV+ apoptosis inducers belong mainly to asymptomatic HIV-infected patients, indicating that immune complexes from these patients can destroy CD4+ lymphocytes.

Adult↗
PubMed1996

[Histopathology of bone marrow biopsy in patients with human immunodeficiency virus infection].

PURPOSE: To describe morphology of bone marrow (BM) biopsy in HIV infected patients. To correlate histopathologic findings and clinico-haematological data. To consider the advantages of this method (BM biopsy) in the diagnosis of secondary infectious or tumoural accompanying processes. MATERIAL AND METHODS: One hundred and fourteen BM biopsies of 103 HIV infected patients were retrospectively reviewed. The cases were selected from the records of Pathology Department of Jiménez Díaz-Foundation (from 1984 to 1993). All cases were studied with routine and immunohistochemical (IHQ) techniques against haematopoietic and proliferative markers. Clinico-haematological data were also reviewed. RESULTS: Ninety per cent of biopsies showed morphological abnormalities: hypercellularity, myeloid hyperplasia and dysplasia of erythroid and megacariocytic series. Reticuline myelofibrosis and reactive lymphoplasmacytosis were also present. IHQ confirms the described histopathologic pattern. Twenty-two per cent of cases showed signs of infectious or tumoural diseases: mycobacteriosis (15%) and lymphomas (7%). Clinical manifestations were correlated with significant alterations in the BM: fever with hypercelullarity, constitutional syndrome and myelofibrosis with zidovudine therapy and infections with myelodysplasia. CONCLUSIONS: Cytology, myelofibrosis and abnormal pattern of BM biopsies in HIV infected patients are characteristic: "the so-called AIDS BM pattern" as BM is a target organ in the HIV-related infections. BM biopsies are a good method to demonstrate stage of HIV disease and accompanying infectious or tumoural processes.

Adult↗
PubMed1995

Comparison of the onset and duration of the analgesic effect of dipyrone, 1 or 2 g, by the intramuscular or intravenous route, in acute renal colic.

In a double-blind, double-dummy randomized controlled clinical trial, the onset and duration of the analgesic effect of dipyrone, 1 or 2 g, and diclofenac sodium, 75 mg, by either the i.m. or the i.v. route were compared in 293 patients (aged 18-70 years) with acute renal colic. A level of > or = 50 mm on the 100-mm visual analogue scale was required for inclusion in the study. Patients were randomly allocated to six treatment groups, receiving dipyrone 1 g i.m., dipyrone 1 g i.v., dipyrone 2 g i.m.;, dipyrone 2 g i.v., diclofenac sodium 75 mg i.m.; and diclofenac sodium 75 mg i.v., respectively. Evaluations were performed at 10, 20, 30, and 60 min and 2, 4, and 6 h after treatment (time 0). Primary efficacy end points included course of pain, total pain, percentage of patients with a pain improvement of 50% or more at each evaluation time, pain intensity evaluated by the investigator on a 0-3 scale, and differences in pain intensity. The analgesic response was more marked and prolonged among patients receiving dipyrone 2 g i.m. or dipyrone 2 g i.v. There were no significant differences between dipyrone 1 g and diclofenac sodium 75 mg, by either the i.m. or the i.v. route. All treatment regimens were well tolerated.

Adult↗
PubMed1995

Anti-CD4 activity in circulating immune complexes in HIV-infected patients.

Levels of circulating immune complexes (CIC) measured by precipitation with 1.04 M ammonium sulfate ranged from 22 to 2,040 micrograms/ml in a group of 141 HIV-infected patients. CIC were elevated (> 200 micrograms/ml) in 72.2% of infected individuals. When analyzed for their HIV antigen composition, those CIC containing HIV antigens were found more frequently in patients clinically affected (68.6%) than in asymptomatic individuals (31.4%; p < 0.001). Anti-CD4 activity of 89 isolated CIC was detected in 43.8% of these patients, but only in 7.6% of the cases these CIC could bind to native CD4+ molecules. CIC with anti-CD4 activity could inhibit PHA stimulation of normal peripheral blood lymphocytes. Anti-CD4 activity in CIC was independent of the clinical and immunological status of HIV-infected patients.

Antibodies↗
PubMed1991

Nosocomial pneumonia: comparative multicentre trial between monotherapy with cefotaxime and treatment with antibiotic combinations.

In a multicentre clinical trial involving 32 hospitals, 588 adult patients diagnosed with nosocomial pneumonia and not receiving mechanical ventilation were treated randomly with monotherapy with cefotaxime or the antibiotic combination routinely used in each particular hospital. Both groups of patients were similar regarding demographic data, concurrent diseases, additional therapies and causative organism. Protocol violations were recorded in 40 patients, and these patients were excluded from the evaluation of treatment efficacy. The cure rate was 79% in the cefotaxime group and 71% in the group receiving antibiotic combinations; this difference is statistically significant (p = 0.03, Fisher's two-tailed test). In the patients receiving combinations of cephalosporins having activity predominantly against gram-positive organisms plus aminoglycosides, the cure rate obtained was very low. The frequency of serious adverse reactions was significantly higher in the group treated with antibiotic combinations. It is concluded that monotherapy with cefotaxime is the regimen that offers better results for the empirical treatment of nosocomial pneumonia.

Adolescent↗
PubMed1990

Spanish experience with teicoplanin.

Teicoplanin, a narrow spectrum glycopeptide antibiotic was prospectively evaluated in an open, non-comparative manner in three Spanish university hospitals. A total of 65 patients were treated (25 females and 40 males: median age 45 years) for the following severe infections: endocarditis (5), bone and joint (9), lower respiratory (6), septicaemia (21), skin and soft tissue (13) and other miscellaneous infections (11). The median dose given was 6.8 mg/kg (range 1.0-15.1 mg/kg), for a median duration of 12 days. A total of 70 organisms were isolated, of which the most common was Staphylococcus aureus, followed by coagulase-negative staphylococci. Of these 70 organisms, 44 were eliminated by teicoplanin therapy, while 10 organisms persisted. Clinical cure was considered to have been achieved in 75% of patients, while 11% showed some improvement, leaving 11% in whom therapy had failed. The safety of teicoplanin was considered to be acceptable, only 16 out of 65 patients experiencing one or more adverse events. Of 23 adverse events, two were described as severe, the remainder being either moderate or mild. No effects due to age or dose on the safety of teicoplanin were noted. These results are in keeping with those previously reported by other groups in Western Europe, and confirm the good safety profile of teicoplanin at a dose of 6 mg/kg. Further studies are now needed to compare teicoplanin with standard antibiotic regimens.

Adolescent↗
PubMed1990

Pleuropulmonary infections due to nontyphoid strains of Salmonella.

Medical records of 11 patients with nontyphoid Salmonella pleuropulmonary disease studied from 1960 to 1986 in a general hospital were reviewed. Eight patients (73%) were 60 years old or older, and the median age was in the seventh decade. There was no seasonal variation in the prevalence. The infection was hospital acquired in 4 patients (36%). All patients had one or more (median, 1.5) major underlying diseases. Seven of them had previous abnormalities of the lung or pleura. Severe immunosuppression was present in 7 cases. Pneumonia occurred in 8 patients, lung abscesses in 2, and empyema in 1. All patients with pneumonia had positive blood cultures. A gastrointestinal source of pulmonary infection was not probable because only 2 patients had positive stool cultures. We suggest that the reticulo-endothelial system could be the source of hematogenous spread of nontyphoid Salmonella. The overall mortality was 63%. Pulmonary infection due to Salmonella should be considered among the pathogens associated with gram-negative bacillary pneumonia in elderly patients who are immunosuppressed and have underlying pulmonary disease. Pathogenesis of this infection remains to be clarified.

Adult↗
PubMedDate not supplied

[Indinavir and renal lithiasis].

Indinavir is a new specific and potent drug that inhibits, like other antiretroviral agents, the protease of immune deficiency virus (HIV) or acquired immune deficiency syndrome (AIDS), an enzyme necessary to maduration and replication of the virus. Indinavir has the capacity to bind the active site causing a decrease in plasma of HIV1-RNA and an increase of T-CD4 helper lymphocytes. The aim of this work is to study in HIV and/or AIDS patients treated with indinavir the crystalluria and the formation of renal calculi due to the clearance of this drug. Two out of nine patients studied in this work presented abundant crystalluria and one of them presented spontaneously passed renal stone. Urinary crystals were studied under polarized-light microscopy and renal stone was analyzed by infrared spectroscopy.

HIV Infections↗