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Biomedical subjects

M L Miranda

Publications and source records attributed to M L Miranda.

32 records · Page 2Linked to original sources
PubMed1990

Norfloxacin prevents spontaneous bacterial peritonitis recurrence in cirrhosis: results of a double-blind, placebo-controlled trial.

Eighty cirrhotic patients who had recovered from an episode of spontaneous bacterial peritonitis were included in a multicenter, double-blind trial aimed at comparing long-term norfloxacin administration (400 mg/day; 40 patients) vs. placebo (40 patients) in the prevention of spontaneous bacterial peritonitis recurrence. At entry, both groups were similar with respect to clinical and laboratory data, ascitic fluid protein and polymorphonuclear concentrations, number of previous episodes of spontaneous bacterial peritonitis and causative organisms of the index spontaneous bacterial peritonitis. Norfloxacin administration produced a selective intestinal decontamination (elimination of aerobic gram-negative bacilli from the fecal flora without significant changes in other microorganisms) throughout the study in six patients in whom the effect of norfloxacin on the fecal flora was periodically assessed. Fourteen patients from the placebo group (35%) and five from the norfloxacin group (12%) developed spontaneous bacterial peritonitis recurrence during follow-up (chi 2 = 5.97; p = 0.014) (mean follow-up period = 6.4 +/- 0.6 mo; range = 1 to 19 mo). Ten of the 14 spontaneous bacterial peritonitis recurrences in the placebo group and only one of the five spontaneous bacterial peritonitis recurrences in the norfloxacin group were caused by aerobic gram-negative bacilli (chi 2 = 8.87; p = 0.0029). The overall probability of spontaneous bacterial peritonitis recurrence at 1 yr of follow-up was 20% in the norfloxacin group and 68% in the placebo group (p = 0.0063) and the probability of spontaneous bacterial peritonitis recurrence caused by aerobic gram-negative bacilli at 1 yr of follow-up was 3% and 60%, respectively (p = 0.0013).(ABSTRACT TRUNCATED AT 250 WORDS)

Bacterial Infections↗
PubMed1990

[Cervical actinomycosis starting as a monoparesis of the upper left extremity].

We present a case of cervical actinomycosis which due to its localization, unusually low and posterior, made its debut as a monoparesis and which due to its unexpected size, marked aggressiveness, and radiologic image mimicked a tumor. We have not found in the literature this kind of presentation up to date. Although sulphur grains were not observed, empiric treatment could be started based on the Gram stain information. Culture was delayed 15 days, but we could promptly obtain reliable diagnosis thanks to pathologic study. Associated Pseudomonas aeruginosa was isolated.

Abscess↗
PubMed1989

Arterial hypertension as a complication of prolonged ketoconazole treatment.

Two of 14 patients with Cushing's syndrome treated on a long-term basis with ketoconazole developed sustained hypertension. In both cases normal plasma and urinary free cortisol levels had been achieved following ketoconazole therapy, yet continuous blood pressure monitoring demonstrated hypertension 31 (patient 1) and 52 weeks (patient 2) after treatment. In patient 1, plasma levels of deoxycorticosterone and 11-deoxycortisol were elevated. In patient 2, in addition to an increase in both deoxycorticosterone and 11-deoxycortisol levels, plasma aldosterone values were raised, with a concomitant suppression of renin levels. Our findings show that long-term treatment with high doses of ketoconazole may induce enzyme blockade leading to mineralocorticoid-related hypertension.

Adolescent↗
PubMedDate not supplied

Cryptococcal peritonitis: report of a case and review of the literature.

We describe a patient diagnosed with AIDS and cirrhosis who had recently suffered a self-limited and non-specific esophageal ulceration. After this, he was hospitalized because of an oral bleeding with fatal evolution, and Cryptococcus neoformans was isolated from ascitic fluid during a routine paracenteses. We have reviewed the literature and, since 1963, only another 10 cases of cryptococcal peritonitis have been reported. A liver disease and not the AIDS (surprisingly, our case is the only report of cryptococcal peritonitis in a subject having both diseases) was the most common underlying disease (72.7%) and was associated with the worst prognosis (only one patient survived). An oral or upper gastrointestinal bleeding was the most common associated circumstance although recent steroid or antibiotic therapy has been also reported. Finally, diagnosis was delayed in many patients. The reasons for these delays are discussed.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[The use of brief questionnaire in the diagnosis of attention deficit. Study group of the Manizales University Foundation].

INTRODUCTION: American Psychiatric Association has defined the DSM-IV ADD diagnostic criteria and symptoms, however, there is not a quantitative instrument to evaluate them in Spanish speaker population. OBJECTIVE: To evaluate the utility of a ADD checklist in a Colombian schooling population. PATIENTS AND METHODS: A randomized and stratified by sex, age and socioeconomic level, 4 to 17-year old, sample of 540 schooling subjects was selected from Manizales City, Colombia. An ADD checklist was applied to the parents of these subjects. RESULTS: The reliability of the different dimensions of the questionnaire (18 total items, 9 items for inattention, 9 for hyperactivity-impulsivity, and 6 for hyperactivity) were strong in both sex and in all age groups (Cronbach's alpha coefficient 0.71-0.92). Only the impulsivity dimension formed by three variables showed fairly weak reliability (0.42-0.79 Cronbach's alpha). Some factorial analysis found two dimensions. In the male sample first dimension (inattention) explain around the 45% of the variance, and the second dimension (hyperactivity-impulsivity) explain around the 12 to 15% of the variance in the different age groups. In the female sample the first dimension was hyperactivity-impulsivity and the second dimension was inattention. A categorical (yes or not) scored questionnaire found a ADD estimated prevalence of 16.1, distributed in type I (combined) 3.3%, in type II (inattentive) 4.3%, and type III (hyperactive-impulsive) 8.5%. Male prevalence was 19.8% and female 12.4%. CONCLUSIONS: ADD checklist Spanish version showed a strong reliability. A bidimensional stable structured was found. A clinical related ADD prevalence was presented, it was much higher than the prevalence of the developed countries.

Adolescent↗