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Biomedical subjects

M Montejo

Publications and source records attributed to M Montejo.

At least 37 records · Page 2Linked to original sources
PubMed1997

Inborn errors of metabolism with a protein-restricted diet: effect on polyunsaturated fatty acids.

Previous studies have shown that phenylketonuric patients display a deficiency in long-chain polyunsaturated fatty acids. A study has now been performed on 13 cases (5 with methylmalonic acidaemia and 8 with urea cycle disorders) whose dietary treatment also implies a limitation in protein-rich food. Plasma and red-cell phospholipid fatty acid profiles were studied. The most relevant results were a lower percentage of docosahexaenoic acid in plasma and red-cell phospholipids (0.91% +/- 0.53% vs 2.88% +/- 1.17% and 2.07% +/- 0.92% vs 3.62% +/- 1.01% (p < 0.001)) and a lower percentage of arachidonic acid in plasma (5.22% +/- 2.02% vs 8.3% +/- 2.11% (p < 0.001)). A long-chain polyunsaturated acid deficiency has also been confirmed in this group of metabolic patients and a dietary supplement is recommended since this population is subject to a special risk factor with regard to adequate psychomotor development. By extrapolating these data to the general population, the possibility can be inferred that long-chain polyunsaturated fatty acids are semi-essential in infant nutrition far beyond the breast-feeding period.

Amino Acid Metabolism, Inborn Errors↗
PubMed1997

[Otomastoiditis caused by Aspergillus in AIDS].

BACKGROUND: Aspergillus otomastoiditis is an infrequent infection that occurs in most cases in immunocompromised hosts. Although fungal infections are common in AIDS patients, few cases of Aspergillus otomastoiditis have been reported. METHODS: Two clinical cases of AIDS patients with Aspergillus otomastoiditis are reported, and a review of the literature is performed. RESULTS: Clinical presentation in both cases was similar to those of other diseases involving middle and internal ear. Infection was linked to severe immunosuppression (C3 group). CONCLUSIONS: Aspergillus otomastoiditis is an infrequent infection in AIDS patients. Different routes by which Aspergillus obtains access to the middle ear have been proposed (tympanogenic, meningogenic, hematogenous and direct spread from paranasal sinuses or external auditory canal). Otorrhea, otalgia, hearing loss and facial nerve involvement are common findings. Bone destruction and invasion of brain or skull base may occur. CT or MRI are necessary to evaluate the extent of the disease. Etiologic diagnosis requires histopathologic confirmation on deep tissue biopsy or isolation from blood cultures or fistula exudates, because Aspergillus is a common saprophytic fungus in external auditory canal. Concurrent infections (i.e. Pseudomonas aeruginosa) frequently delay the correct diagnosis. Aggressive surgical resection and intravenous antifungal chemotherapy (amphotericin B or itraconazole) are the main therapeutic options. Outcome is poor as a consequence of severity, delay of etiologic diagnosis and difficulty of aggressive surgical approach in compromised patients. In patients with AIDS a low CD4 cell count would favour invasive Aspergillus infection, implying a worse outcome.

AIDS-Related Opportunistic Infections↗
PubMed1993

[Disease caused by Mycobacterium kansasii in patients with HIV infection].

BACKGROUND: To describe the clinical features and response to therapy in Mycobacterium kansasii disease among HIV infected patients, an increasing problem in our setting. METHODS: A retrospective survey of all charts from patients with HIV infection with Mycobacterium kansasii infection recorded between April 1985 and December 1991. RESULTS: A total of 13 patients were identified. All of them had clinically significant respiratory tract samples with a definite M. kansasii isolation. Only three had disseminated disease. In all but two cases, CD4 cell count at diagnosis time was lower than 200/mm3. Chest X-ray films showed interstitial pattern (8 cases) or alveolar condensation (3 cases) and lung cavities were seen in 4 patients. All patients with lung disease and one with disseminated disease responded well to anti-tuberculous therapy. CONCLUSION: Mycobacterium kansasii produces disease in advances stages of HIV-induced immunosuppression. The most common primary location is pulmonary, but disseminated forms can also be seen. The infection can be controlled with standard anti-tuberculous therapy.

AIDS-Related Opportunistic Infections↗
PubMed1992

[Use of magnetic resonance in the diagnosis of neuro-cryptococcosis in the acquired immunodeficiency syndrome: study of 4 patients].

Neuro-cryptococcosis is a common opportunistic infection in AIDS or HIV infected patients. From a series of 10 neuro-cryptococcosis the four of them studied by magnetic resonance (MR) are reported. In AIDS patients a high suspicion of opportunistic infection of the CNS is needed as exemplified by two of the four patients who only presented cephalalgia. The other two patients suffered additional symptoms and signs of meningeal and CNS involvement, such as nuchal rigidity, cranial nerve palsies, papilloedema, gait ataxia and dismetria. Diagnosis was achieved (confirmed) by a positive culture, serology or indian ink test in CSF. CT scan did not contribute to the diagnosis and management of the patients. In contrast MR, showed in three of them a peculiar pattern of small, confluent, high-signal lesions, roughly symmetrically placed in the basal ganglia and the internal capsule. They probably correspond to the dilated Virchow-Robin spaces through which torulae migrate from the subarachnoid space.

Acquired Immunodeficiency Syndrome↗
PubMed1992

[Endocarditis caused by Lactobacillus].

Endocarditis due to Lactobacillus is rare. Its main features were a subacute course and greater difficulties for achieving a complete recovery even using appropriate antimicrobial therapy with serum levels above MIC. We present one case of Lactobacillus endocarditis in a patient with allergy to penicillin, due to a vancomycin-resistant strain. She was successfully treated with clindamycin and gentamicin. We emphasize the need and importance of sensitivity tests and antibiotic tolerance when choosing an optimal treatment for this infection.

Adult↗
PubMed1992

[Cryptococcal meningitis and AIDS. Clinical description of 10 patients].

We have studied 10 patients with cryptococcal meningitis and AIDS. Nine of them were intravenous drug users and four have been previously diagnosed of AIDS. In 60% of them cryptococcal meningitis was the first opportunistic infection, and as group represented only 6.3% of our 158 patients with AIDS on the same period. The most common symptoms were: malaise (100%), headache (80%), fever (60%), meningeal signs (50%). Two of them had focal neurological disease. CSF culture and serum cryptococcal antigen test were positive in 90%, the Indian ink in 77% and blood cultures in 30% of the cases, while indian ink preparation did it in 77%. MRI showed bilateral small lesions, deeply located, in 3 cases; it was also useful to prove optical tract lesions in a patient with blindness as a result of cryptococcal meningitis. We had treatment successes in 80% of the cases, all patients being treated with amphotericin B, alone in 4 and amphotericin B plus fluorocytosine in 6. Two patients died within the first 2 weeks. Maintenance therapy with fluconazole was effective and well tolerated, with 3 patients dying from causes other than cryptococcal meningitis. We recorded a survival rate over 12 months in 33% of patients.

Acquired Immunodeficiency Syndrome↗