Biomedical subjects
M S Moya Mir
Publications and source records attributed to M S Moya Mir.
[Health care management: coordination of health care assistance levels].
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[Acute bacterial meningitis in adults: a clinical and developmental analysis of 100 cases].
BACKGROUND: Characterize clinical findings and outcome of acute bacterial meningitis (ABM) in adults, with special emphasis on nosocomial meningitis and meningitis in the elderly. METHODS: We reviewed the charts of all persons 14 years of age or older in whom ABM was diagnosed in our hospital during a 12 and a half-year period. RESULTS: Ninety-seven patients were treated for 100 episodes of ABM, of which 23 percent were nosocomial and 27 percent occurred in elderly persons. Predisposing factors were present in 59 percent of the episodes. Fifty-four percent had the classic triad of fever, nuchal rigidity, and change in mental status. Cerebrospinal fluid pleocytosis with a neutrophilic predominance, hypoglycorrhachia, and elevated protein levels were present in 62 percent of the episodes. A pathogen was identified in 62 percent of the cases, in a higher frequency in elderly persons (p < 0.05) and in patients who had not received antibiotics before the lumbar puncture (p < 0.05). Causal agents more frequently identified were: Streptococcus pneumoniae (27 percent) in community-acquired meningitis, coagulase-negative Staphylococci (35 percent) in nosocomial meningitis, and Strep. pneumoniae (33 percent) in elderly persons. Central nervous system (CNS) complications occurred in 18 percent of episodes, and 15 percent developed systemic complications. The overall mortality rate was 9 percent, higher among patients in whom CNS complications began within 24 hours of admission (p < 0.05). CONCLUSIONS: A high proportion of cases of ABM in adults are nosocomial, or affect elderly persons. The fatality rate is high, particularly among those who develop CNS complications at the onset of the disease.
[Colonic adenocarcinoma: its presentation as a fever of unknown origin].
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[Sudden death and sports].
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[Cholesterol in the pleural fluid].
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[Primary cutaneous nocardiosis and the acquired immunodeficiency syndrome].
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[Arthritis caused by Pneumococcus].
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[Reversibility of alcoholic myocardiopathy].
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[Subacute thyroiditis as a cause of prolonged fever diagnosed by gallium scan].
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[Acquired immunodeficiency syndrome (AIDS) in a homosexual male with tuberculosis and medullary hyperplasia].
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[Toxic typhoid encephalopathy with mesencephalic and basal ganglia involvement].
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[Primary fibrinolysis and adenocarcinoma of the prostate: presentation of 2 cases].
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[Stevens-Johnson syndrome and Mycoplasma pneumoniae infection: presentation of 2 cases].
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[Disseminated lupus erythematosus induced by isoniazid manifesting as prolonged fever. Presentation of a case].
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[Boutonneuse fever. Analysis of 8 cases].
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[Giant cell arteritis: diagnostic value of a second biopsy of the temporal artery (author's transl)].
A 79-year old female patient with antecedents of headache and fever, was admitted because of fatigue, anorexia, anemia and elevated ESR. After admission she presented with rheumatic polymyalgia and synovial effusion in the knee. A first biopsy of the temporal artery was normal. After dismissing other possible causes a second biopsy of the contralateral temporal artery was bone and confirmed giant cell arteritis. Diagnostic value of a second temporal artery biopsy is discussed and justified by: a) a confirmed diagnosis is necessary for prolonged treatment with corticosteroids, b) if it is decided to treat the rheumatic polymyalgia with lower doses of corticosteroids than for temporal arteritis the certainty that no temporal arteritis is present and c) shortening the hospital stay and lowering the cost and number of diagnostic procedures. The frequency of arthritis and synovial effusion in temporal arteritis are also discussed.
[Cardiomyopathy and pheochromocytoma. Presentation of a case].
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