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Biomedical subjects

M J García de Miguel

Publications and source records attributed to M J García de Miguel.

10 recordsLinked to original sources
PubMed2003

Achromobacter xylosoxidans bacteremia: a 10-year analysis of 54 cases.

Fifty-four cases of Achromobacter xylosoxidans bacteremia diagnosed over a 10-year period in patients from 2 months to 87 years of age were reviewed. Fifty-two episodes were nosocomial. The most frequent underlying condition was neoplasm (solid or hematological). The source of infection was a contaminated intravenous catheter in 35 patients (60%) and pneumonia in 6 patients. Eight (15%) patients died. The only risk factors significantly associated with mortality were age over 65 years and neutropenia. The results of in vitro susceptibility studies of the isolates showed that antibiotic therapy with antipseudomonal penicillins or carbapenems would be a reasonable choice. An epidemiological study conducted in the hemodialysis unit showed Achromobacter xylosoxidans in tap water and on the hands of two healthcare workers but not in the hemodialysis systems. Patients were probably contaminated when healthcare workers manipulated the intravenous catheters without wearing gloves.

Adolescent↗
PubMed2003

[Short course treatment for visceral leishmaniasis with liposomal amphotericin B in immunocompetent patients].

INTRODUCTION: Visceral leishmaniasis is endemic in southern Europe. Traditional treatment consists of pentavalent antimonial compounds. However, treatment failures, the treatment's long duration, and toxicity have led to the introduction of new therapies, such as liposomal amphotericin B (LAB). In this study we evaluate the safety and efficacy of LAB at a maximum dose of 4 mg/kg/day on days 1, 2, 3, 4, 5, and 10. PATIENTS AND METHODS: A prospective, observational, open study was conducted in 13 Spanish centers. The diagnosis of visceral leishmaniasis was based on visualization of Leishmanias sp. in bone marrow aspirate or culture or positive serology together with compatible clinical symptoms. RESULTS: Thirty-two immunocompetent children aged from 7 months to 7 years were treated. All the children had rapid clinical response and bone marrow aspirate performed on day 21 was normal in the 24 patients (100 %) who underwent this procedure. In the remaining eight children efficacy was assessed by clinical response. Two relapses were observed. Cure was achieved in 18 patients (90.0 %) and in 87.5 % of the patients with microbiological confirmation of the disease. No adverse events were detected. CONCLUSIONS: A total dosage of 24 mg/kg of liposomal amphotericin B administered in 6 doses within 10 days is safe and effective for the treatment of visceral leishmaniasis and reduces the length of hospital stay.

Amphotericin B↗
PubMed1998

[Brain stem encephalitis in childhood].

OBJECTIVE: To present two cases of post-infectious encephalitis of the brain stem (ETC) in infancy, which is very infrequent at this age. CLINICAL CASES: Two patients aged 4 months and 9 months respectively had a previous history of a catarrhal illness a few days before the onset of encephalitis. The clinical condition was of subacute onset and torpid course, characterized by ataxia, reduced level of consciousness, involvement of the pyramidal tracts and paralysis of the cranial nerves. No significant information for the diagnosis of either case was obtained from CT. MR showed lesions at the level of the pons. However, the MR image did not correspond in seventy to the clinical condition. The clinical courses of the two patients were different. One case recovered with no sequelae. In the other case the cranial nerves and gait did not return to normal. CONCLUSIONS: In our experience, ETC is rarely seen in infancy. A high degree of suspicion and early treatment of ETC caused by the herpes simplex virus is necessary, since there is usually a high mortality or serious neurological sequelae.

Ataxia↗
PubMed1992

[Chemoprophylaxis of tuberculosis: compliance to treatment in the pediatric population].

We have reviewed the success of tuberculosis chemoprophylaxis in 369 children. These children ranged from 4 months to 14 years of age and had been prescribed chemoprophylaxis with Isoniazide at 10 mg/kg/day. Out of these, 258 (69.91%) finished the prophylaxis and 111 (30.08%) did not. Taking into account the reason for the consultation, of those who sought assistance due to contact with a patient with tuberculosis, 70.33% performed the treatment and 29.60% did not. For those in which the reason was a positive Mantoux, the data were 68.1% and 30.8%, respectively. No statistically significant differences were found between the two groups. We feel that the relatively high rate of noncompliance in our patients is a matter of concern. At the present time, chemoprophylaxis with Isoniazide is the best method available for the prevention of tuberculosis. We emphasize the need for its proper performance. We report several measures, such as the determination of Isoniazide metabolites in urine, which may be beneficial for better control and follow-up of these patients.

Adolescent↗
PubMed1990

[Pulmonary tuberculosis in infants: apropos of 149 cases].

One hundred and forty-nine cases of childhood pulmonary tuberculosis were analysed being a 77.6% of the 192 cases of tuberculosis diagnosed at the Pediatric Infectious Diseases Department of "La Paz" Hospital, in a ten year period. The children were aged 3 months to 14 years; 65% of them were less than 6 years of age. The source case was found in 67.1% of the children. The primary means of diagnosis was contact screening (38.1%), followed by a 27.5% that presented with non-specific symptoms, while 18.1% of the cases presented with respiratory symptoms. Gastric aspirates yield the organism in 25.8% of cases. Radiologically the following was found: 38.9% mixed patterns, 32.2% nodal patterns, 23.4% parenchymal patterns, 1.34 miliary tuberculosis, 1.34% caverns and 2.68% pleural effusions. Right lung location was more frequent in parenchymatous forms (68%), as well as in nodal forms (61.5%). The duration of the course of therapy changed along this ten years period: from twelve months initially to ten months posteriorly, subsequently becoming a six month course of treatment. All cases experienced full recovery.

Adolescent↗
PubMedDate not supplied

Cellular immunodeficiency with immunoglobulins: treatment with a thymus implant in millipore diffusion chambers.

A 14 month old male affected by cellular immunodeficiency with immunoglobulins underwent implantation of a thymus enclosed in Millipore diffusion chambers. Five days after the implant the percentage of T lymphocytes forming spontaneous rosettes reached normal levels. One month later responsiveness to PHA was demonstrated in the patient's lymphocytes and IgG and IgM serum levels showed a marked increase. Positive skin tests were elicited 6 month's post-implant. An inguinal lymph node biopsy showed developing primary follicles and germinal centers. The patient's condition improved significantly. One year after the implant the patient died from irreversible neurological deterioration. It is suggested that partial immunological reconstitution was achieved by thymic humoral factors.

Antibodies↗