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Biomedical subjects

M Moreno Azcoita

Publications and source records attributed to M Moreno Azcoita.

At least 19 recordsLinked to original sources
PubMed1998

[Prospective randomized trial of meropenem versus cefotaxime and metronidazole in the treatment of intraabdominal infections].

BACKGROUND: The empiric antibiotic treatment of intraabdominal infections is in constant evolution. Monotherapy appears to be a desirable goal because of the simplicity of its administration, lack of toxic effects and wide spectrum. PATIENTS AND METHODS: A multicentre, prospective, randomized, open study was carried out to compare two antibiotic regimens in the treatment of intraabdominal infections in patients undergoing surgery. Ninety-eight consecutive patients were randomly allocated into two groups. One group (GM, n = 51) received meropenem (1 g/8 h) and the other (GCM, n = 47) a combination of cefotaxime (2 g/8 h) plus metronidazol (0.5 g/8 h). Clinical and bacteriological responses were assessed at the end of treatment and at 2-4 weeks. RESULTS: The severity of patients as assessed by the APACHE II score was similar in both groups (GM: 7.2 and GCM: 8.1). Three patients in each group could not be evaluated due to premature interruption of treatment or deviation from the protocol. The mean duration of treatment was 7.4 days in GM and 7.9 days in GCM. A satisfactory clinical response was obtained in 95% of patients in both groups. 31 patients (61%) in GM and 26 patients (55%) in GCM were bacteriologically evaluable. Bacteriological erradication was achieved in 94% of patients in GM and in 92% of patients in GCM. CONCLUSION: Meropenem is a good alternative for single antibiotic therapy in intraabdominal infections of moderate severity.

Abdomen↗
PubMed1997

[Diagnostic validity of signs and symptoms defining the diagnosis of acute appendicitis].

A prospective study of 810 consecutive cases submitted to emergency appendicectomy was performed to determine the predictive value of abdominal pain, nausea, vomiting, fever, abdominal tenderness and total and differential leucocyte count in the diagnosis of appendicitis. Age, sex, time of evolution and degree of inflammation were considered as conditioning factors. Most of the cases were diagnosed within the first 12 h. Pain demonstrated acceptable sensitivity (85.2%) and a high positive predictive value (95.7%) but with an important proportion of false negatives (14.8%). The predictive value of abdominal exploration was 97.6% with a sensitivity of 96.1%. Leucocytosis increased with the degree of inflammation and values above the cut off point established (12,500 leucocytes/dl and 85% segmented) significantly increased the strength of the association. Pain on palpation and leucocytosis with shift to the left increased the sensitivity to 98.1% with false positives of 1.3%. The percentage of acute perforated appendicitis increased from 5 to 15.3% when diagnosis was delayed more than 12 h. Once the clinical manifestations and analytical alterations were established (6 h after initiation of the clinical picture) these did not modify with the time of evolution. The greater the involvement of the appendix the earlier the presentation although, logically, the later the diagnosis the greater the percentage of perforated appendix. The classical criteria of pain, tenderness and leucocytosis with left deviation does not allow the diagnosis of 1.9% of the cases of appendicitis with 1.3% of false positives. Once the clinical manifestations are established, these do not modify with the time of evolution, but the percentage of perforations does increase with time. To reduce this percentage, diagnosis must be made within the first 24 h.

Acute Disease↗
PubMed1997

[Nonepithelial malignant degeneration of esophageal duplication].

A communicating duplication of the distal esophagus was diagnosed in an elderly patient. The lesion was removed and the connection with the esophageal lumen closed. A high grade leiomyosarcoma involving all duplication layers and the right pleural surface was demonstrated. This is the first reported instance of a nonepithelial malignant tumor in an alimentary tract duplication.

Age Factors↗
PubMed1997

[Gas gangrene secondary to carcinoma of the colon].

Systemic infections due to enteric bacteria can develop in patients with occult intestinal tumours. A patient with a sigmoid adenocarcinoma that developed crepitation and necrosis of soft tissues in gluteous region and thigh of left lower limb is presented. No pus or free fluid was observed in the peritoneal cavity; a sigmoid tumor infiltrating and perforating the retroperitoneum with necrosis of the psoas muscle was found. The infection spread subsequently through the inguinal canals and sciatic foramen to the lower limb. Necrotizing infections of soft tissues without previous trauma or ischemic accident leads to the suspicion of an occult digestive disease.

Adenocarcinoma↗
PubMed1995

[Pseudomyxoma peritonei].

Pseudomyxoma peritonei is an infrequent clinical entity, characterized by peritoneal implantations organized in cyst of mucine or free peritoneal mucine. Most arise from cystadenoma or cystadenocarcinoma of the ovary and appendix, and fewer from other tumours and locations. It is more common in females, and it is usually diagnosed over the fifth decade. Three cases of pseudomyxoma peritonei are presented, two associated to appendicular carcinoma and one to carcinoma of the ovary, and the data published about this disease are reviewed.

Aged↗
PubMed1995

[Epithelioid hemangioendothelioma localized in the small intestine].

Epithelioid hemangioendothelioma is a unique tumor of adult life which is characterized by epithelioid or histiocytoid endothelial cells. These tumors are rare, and developed preferentially in the dermis and subcutaneous tissues of the distal extremities. They grow in a slowly progressive fashion, have a borderline biological behavior, and a good response to surgical treatment. The authors present a 63-years-old woman with an epithelioid hemangioendothelioma localized in small intestine. The patient had a history of abdominal pain and recurrent rectal bleeding being surgically treated.

Fatal Outcome↗