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Biomedical subjects

M Rodríguez

Publications and source records attributed to M Rodríguez.

At least 433 records · Page 24Linked to original sources
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[1st isolation of vancomycin-resistant Enterococcus faecium with the vanB genotype in Argentina: presentation of 2 cases].

We describe the first isolate of van B vancomycin-resistant Enterococcus faecium in Argentina. The strains were recovered from ambulatory patients admitted to a hospital of Buenos Aires city in July 2000. They were not high-risk patients, they had not received previous antibiotic therapy, and they were assisted in different services. MICs for vancomycin were 32 micrograms/ml for both strains, whereas MICs for teicoplanin were 0.12 microgram/ml in case 1 and 0.25 microgram/ml in case 2. PCR was performed to confirm the vanB genotype. The molecular fingerprints of the isolations by PFGE revealed that they were identical. No further VanB strains were isolated in the hospital.

Adult↗
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[Non ulcer dyspepsia, endoscopic gastritis and Helicobacter pylori].

We studied 33 patients with non ulcer dyspepsia and endoscopic gastritis. 21 were female (63.4%) and 12 male (36.4%). Helicobacter pylori (HP) was investigated by gastric mucosal biopsy. Urease test, Gram, culture, and histology were performed in all and two or more of these test hat to be positive to consider HP infection. 16/33 resulted HP positive (48.8%). Erosive gastritis was most commonly associated with H.P. infection (62.5%). This was statistically significant. In all the cases HP positive chronic gastritis was present. 15/16 were active chronic gastritis. Our results suggest that erosive gastritis is most frequently associated with HP infection and non ulcer dyspepsia.

Adolescent↗
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Bronchial asthma due to sensitization to chloramine T.

Chloramine T, an organic, highly reactive derivative of chlorine with potent bactericidal properties, is used as a disinfectant in the food industry. Described as an occupational sensitizer in 1945 for the first time, it produces late or dual asthma, occasionally accompanied by fever and leukocytosis, which is mediated by IgE. We present the case of a male dairy worker who, after 4 years of exposure to the product, developed rhinitis and asthma. Skin tests with chloramine T were positive at a concentration of 10 mg/ml, while all other allergens tested negative. RAST detected specific IgE at 12 PRU and bronchial provocation induced immediate and late bronchoconstriction.

Asthma↗
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[Nutrients and energy intake assessment in the critically ill patient on enteral nutritional therapy].

INTRODUCTION AND OBJECTIVES: The critically ill patient is especially susceptible to malnutrition due to his/her hypermetabolic state that leads to an increase in the nutritional requirementes, which many times are not compensated with the administered enteral formulas. The assessment of nutritional intake is essential in this kind of patients to know to what level their energetic and nutritional requirements are fulfilled, improving and monitoring in the most individualized possible way to indicated clinical and nutritional therapu. METHODOLOGY: This is a retrospective study in which all patients admitted to the Intensive Care Unit of Virgen de las Nieves Hospital were studied from January to December of 2003, aged more than 18 years, and on enteral nutrition. A total of 90 patients (52 men and 38 women) were studied, 81% of which were older than 50 years, and 57% had hospital stays longer than 8 days, with a 21% mortality rate. Intake was assessed from time of admission and throughout the whole hospitalization period. Energetic requirements were calculated according to the modified Long's formula and micronutrients intakes were compared to existing general recommendations for the Spanish, European and American populations, and to vitaminic requirements in critically ill patients. RESULTS: Percentages of mean energy and nutrients intakes in relation to theoretical calculated requirements for both genders are presented in figure 1. Mean energy intake was 1,326 cal in men and 917 cal in women. With regards to micronutrients intake, the values found for proteins, falts, and carbohydrates were lower than 50% of the requirements for both genders. The percentage of adequacy as referred to requirements for vitamins and minerals intake is shown in figure 2. Reference recommendations used correspond to sufficient intakes to cover the healthy individual requirements, therefore, the values obtained in our study show and adequacy greater than 75%, with the exception of particular elements such as vitamin A and magnesium. However, by taking a look at figure 3, which shows the adequacy of vitamins intake at recommended does for sick patients, the intake is lower than 25% of the requirements in all cases, and these deficiencies significantly interfere with wound healing, the immune, cardiovascular and nervous systems, as well as with metabolism of the remaining macronutrients leading to an unbalanced situation of the antioxidant system, worsening the patient's clinical status. CONCLUSIONS: The present study confirms the need for monitoring individually the nutritional requirements in the critically ill patient and adapting recommendations to his/her metabolic changes, since currently these recommendations are not clearly defined for these situations. It is necessary to provide micronutrients doses closer to the patient's demands, so that the nutritional status and the balance of the antioxidant system may be preserved or improved, making the adopted clinical treatment more effective.

Adult↗
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[Clinical and epidemiologic analysis of intestinal tract colonization with vancomycin-resistant enterococci in an intensive care unit].

Intestinal tract colonization with vancomycin resistant enterococci (VRE) was studied during five months and 25 days. Out of 171 patients hospitalized in the intensive care unit, 124 (73%) were included in this study. Thirty five of them (28%) were recognized as colonized with VRE. VRE isolates (n = 35) were identified as Enterococcus faecium (n = 18), Enterococcus gallinarum (n = 16), and Enterococcus raffinosus (n = 1). All of them were resistant to vancomycin (MIC90 = 512 microg/ml) and to teicoplanin (MIC90 = 32 microg/ml), having the vanA gene. By means of molecular methods a high homology was found among E. faecium and E. gallinarum isolates, respectively, suggesting their spread as a kind of outbreak. No significant differences in age or sex were found among colonized and non-colonized patients (p > 0.05). On the other hand, the hospitalization time and the use of broad-spectrum antibiotics were associated with colonization. From this study we highlight the importance of enhancing all measures of control and prevention of hospital infections, carefully analyzing the empiric antimicrobial schemes, trying to reduce the hospital stage, and following the surveillance to evaluate the efficacy of such procedures.

Adolescent↗
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[Incidence of rotavirus in adults with diarrhea in Asunción, Paraguay].

From October 2001 to March 2004, 92 out of 533 (17.3%) fecal samples of patients over 18 years of age were positive for rotavirus. There were not differences of rotavirus incidence between age groups. Although in Paraguay, rotavirus infections in children less than 5 years old present a seasonal peak pattern (since June to October), in adults rotavirus was present throughout the year with the same frequency. Results presented here reinforce the notion that rotavirus should be considered in the differential diagnosis of diarrhea in adults.

Adult↗
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[Microbiological quality of spices consumed in Cuba].

The microbiological quality of some widely consumed spices in Cuba was evaluated by means of aerobic mesophilic microorganisms count, filamentous fungi, yeasts, coliforms, thermophilic and thermoresistant microorganisms. Salmonella spp was looked for too. Black pepper and cumin resulted the most contaminated spices with values of total count and thermoresistant microorganisms at levels of 10(6) per gram, and coliform values up to 10(5) per gram. Oregano and cinnamon showed satisfactory microbiological quality; the contamination detected in these spices was lower than 10(4) per gram. Salmonella spp and yeasts were not detected.

Bacteria↗
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[Nutritional planning of menus of public schools of the community of Madrid].

Some nutritional unbalances have been observed in menus served at dining rooms of schools from the Community of Madrid (CM): small portions, inter-day variations up to 50% of energy intake, unbalances in caloric and lipidic profiles, little variety, lack of parental information, etc. The Education Council of the CM considered necessary to plan and regulate the basic conditions that menus of these dinning rooms should meet. The Spanish Nutrition Foundation (FEN) and the Nutrition Department of the Complutense University of Madrid (UCM) were put in charge of elaborating the bases to develop the Regulation (BOCM 24-05-01, 10-09-02). Collective catering companies were called for a tender to provide menus adapted to such Regulation. This work describes the adaptation of programmed dietary schemes of officially approved companies and mainly the impact on energy and nutritional content of menus and their adaptation to the recommended caloric and lipidic profiles. So far, a random sample of 171 schools with dining rooms (more than 37,000 schoolboys) has been visited by nutritionists, with no previous announcement, to control served menus. For this, at each centre a duplicate of the portion served that day was gathered. The energy and nutrient content was determined and the fatty acid composition was analysed. The adaptation to the Regulation by catering companies has substantially improved the menus as compared to previous times: more presence of vegetables, better quality of fat and less amount of fat and proteins at the expense of carbohydrates.

Child↗
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[Value of three-dimensional measurement of the caudate lobe in the diagnosis of liver cirrhosis by ultrasound].

To assess the changes of the caudate lobe in the sonographic diagnosis of liver cirrhosis, 96 patients were studied at the Hospital Vargas de Caracas. 27 with histologically proved cirrhosis. 43 with other disease (30 no related with liver and 13 with hepatic disease without cirrhosis, and 26 patients without clinical evidence of liver disease. The longitudinal (CL), transverse (CT), and anteroposterior (CAP) diameters of the caudate lobe and the transverse diameter of the right lobe (RL) were measured and one, two and three dimensional caudate lobe, indexes and ratios were calculated. The analysis of these criteria revealed that the ratio of the three dimensional caudate index (C13) to the right lobe diameter (C13)/RL = iCL x CT x CAP/RL was superior to all other calculated criteria.

Adolescent↗
PubMedDate not supplied

[The surgical complications of typhoid fever: a report of 10 cases].

This is a retrospective review of 10 consecutive patients with intra-abdominal complications of typhoid fever requiring surgical treatment, during a four-year period at the Instituto Nacional de la Nutrición Salvador Zubirán. There were 7 males and 3 females with an average age of 33.9 years. In 80 per cent of the cases Salmonella typhi was obtained in blood and bone narrow cultures. Five cases developed terminal ileum perforations, 4 massive bleeding related to ulcerated typhoid ileitis and one patient was operated on with the preoperative diagnosis of acute abdomen during the course of severe, toxic, typhoid fever. At laparotomy, no abnormalities were found. Five patients were treated with right hemicolectomy, 3 with local resections and primary closure, and another one, with segmental terminal ileum resection and end to end anastomosis. One patient died of mixed shock and multiple organ failure. This event was secondary to partial dehiscence of the ileo-transverse anastomosis and massive bleeding. Four patients had complications; a) pneumonia, b) urinary tract infection, c) splenic abscess that required splenectomy and: d) intestinal obstruction. All patients were treated with chloramphenicol. We found a high morbidity and mortality rate of the typhoid fever complications. The surgical resection and specific antibiotic therapy are the most effective treatment, however, complications can appear during its treatment.

Adolescent↗