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M Zabala

Publications and source records attributed to M Zabala.

8 recordsLinked to original sources
PubMed2003

[Early hospital mortality due to infectious diseases].

BACKGROUND: Infectious diseases are an important health problem. Early hospital mortality (EHM) (first 48 hours after hospital admission) give us information about the etiology and the focus of infection. This study was designed because no articles have been found about this subject. MATERIAL AND METHODS: We reviewed the medical records coded by the ICD-9-CM of all patients that suffered from EHM due to infectious diseases during the period 1992 to 1999. RESULTS: Of all the patients analyzed, 0.7% died of EHM, and of theses, 6.9% were due to an infectious disease. Median age was 73.2 years; 56.1% were men. Index of comorbidity was higher than 1 in 59,9%, and 70,7% never has been admitted to the hospital before. At admission, fever was present in 43.9%. The illness severity was 60.9% sepsis, 24.4% severe sepsis, 13.4% septic shock and 1.2% multiorgan failure. Causes of death were respiratory (76.8%; pneumonia 58.5%). Pneumonia was more frequent among aged 65 years and older (p = 0.03). In 69.5% no microbiological techniques were performed with independence of the clinical severity or the presence or absence of fever. In 85.4% the casual agent was unidentified, but in the case of isolation, gram positive was the most frequent microorganism. CONCLUSIONS: Infections are an important cause of EHM, and community-acquired respiratory tract infection (mainly pneumonia) the most frequent cause of EHM. Patients were admitted to the hospital with sepsis in 60.9%, perhaps due to a diagnostic or therapeutic delay. Among aged 65 years and older, microbiological diagnostic procedures were rarely employed.

Adolescent↗
PubMed2002

[Spirometry: quality in the respiratory medicine clinics of a public health care area].

BACKGROUND: Spirometry can be considered a routine way to evaluate patients with respiratory complaints, both inside and outside the hospital setting. OBJECTIVE: To assess the quality of spirometry in a public health care area with respect to two factors: the technicians' performance and the calibration of spirometers. MATERIAL AND METHOD: Four health care clinics were studied. Four technicians participated and the four spirometers were tested at different volumes (calibration syringes 1L and 3L) and different flows (explosive decompression). Eight patients with COPD participated in the study of inter-technician variability. RESULTS: Agreement among the technicians was very high: 0.98-0.99 for FEV1 and 0.91-0.98 for FVC. The mean results obtained by the technicians were: FEV1 = 2.15 0.03, range 2.20-2.14; FVC = 3.25 0.05, range 3.30-3.21 (ns). Volumetric readings from the spirometers were correct for the 1I calibration syringe, but 2 out of 4 spirometers lost linearity with the 3I calibration syringe. One spirometer gave readings out of range for all flow levels, and 2 out of 4 spirometers were out of range at low flows. CONCLUSIONS: 1. Results obtained by different technicians were not significantly different and there was high agreement among them, confirming that performance of spirometry was good. 2. The spirometers showed poor linearity at low flows.

Aged↗
PubMed2000

Seasonality in coastal benthic ecosystems.

For historical reasons, knowledge about seasonality in the dynamics of marine benthic suspension feeders from temperate areas comes mainly from studies of cold temperate seas. Recent surveys of Mediterranean taxa show different patterns from those observed in cold temperate seas, which are characterized by winter dormancy. In the Mediterranean, summer dormancy predominates among taxa and appears to be related to energetic constraints. Temperature and food availability are crucial to the dynamics of benthic suspension feeders. However, because these factors tend to be positively correlated in cold temperate seas, it is difficult to distinguish between their effects. Such correlation does not occur in Mediterranean ecosystems. The contrast between recent studies in the Mediterranean and in other areas can help to disentangle confounded environmental controls.

Journal Article↗
PubMed1995

Skin cancer in heart transplant recipients.

BACKGROUND: The frequency of skin cancer in organ transplant recipients is high, up to 15%. OBJECTIVE: Our purpose was to determine the incidence of skin cancer in patients who underwent immunosuppression after heart transplantation and to determine the factors important in the appearance of skin cancer. METHODS: We studied the frequency of skin cancer in 92 of 111 patients after they underwent heart transplantation between January 1984 and December 1993. RESULTS: At least one cutaneous neoplasm (squamous cell carcinoma and/or basal cell carcinoma) developed in 14 patients (15.2%). The basal cell carcinoma to squamous cell carcinoma ratio was 1:1.5. The skin cancer appeared an average of 31.5 months after transplantation; the average was 36 months for squamous cell carcinoma and 25.3 months for basal cell carcinoma. Cumulative risk rose from 4.3% at 1 year up to 43.8% at 7 years after transplantation. The overall incidence of both types of skin cancer was 45.3 per 1000 posttransplant person-years, with an incidence of 25.8 for basal cell carcinoma and 29.1 for squamous cell carcinoma. Most skin cancers developed between 2 and 3 years after transplantation. All patients were exposed to a significant amount of ultraviolet radiation and had skin type II or III. We did not find a significant association between skin cancer and haplotype HLA-A3, HLA-A11, HLA-DR, and the number of mismatches for HLA-B. CONCLUSION: We found an increased progressive cumulative incidence of skin cancer in heart transplant recipients for two reasons: (1) immunosuppression and increased exposure to ultraviolet radiation in some patients, and (2) the skin type of certain patients. We emphasize the need for photoprotection in this group of patients and regular skin cancer screening examinations.

Adult↗
PubMed1985

Pathologic pulmonary findings in children with the acquired immunodeficiency syndrome: a study of ten cases.

Lung tissue and tissue from the lymphoreticular system obtained at open biopsy and/or autopsy were studied in ten children with the acquired immunodeficiency syndrome (AIDS). One or both parents of nine of the children had AIDS or risk factors for AIDS. The remaining child had hemophilia. The following pulmonary lesions were seen: 1) diffuse alveolar damage (DAD), 2) Pneumocystis carinii and/or cytomegalovirus pneumonitis, 3) lymphoid interstitial pneumonitis (LIP), and 4) desquamative interstitial pneumonitis (DIP). Combinations of such factors as mechanical ventilation, oxygen therapy, and opportunistic infection played a role in the pathogenesis of DAD. Opportunistic infections were related to the defective cell-mediated immunity in these children. The clinical, epidemiologic, immunologic, and pathologic features of the thymuses of these patients indicate that the immune deficiency was unlikely to have been of congenital origin. The immunologic abnormalities may also have been related to the pathogenesis of LIP and DIP. Neither LIP nor DIP has been described in adults with AIDS. Open lung biopsy is of practical importance in the diagnosis and treatment of pulmonary disease in children with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

Corneal sensitivity and topogometry in keratoconus.

Paracentral corneal topography was determined (with a topogometer) and corneal sensitivity was measured in 90 keratoconic eyes. Sensitivity was evaluated in a control group and found to be greater in all five sectors than the sensitivity found in keratoconus patients. The zone of marked corneal steepening was located infero-temporally in 59% of our patients, although steepening was found in other zones as well. Overall, sensitivity was greatest in the temporal cornea and lowest in the inferior cornea, this hypoesthesia coinciding with the area of pronounced corneal protrusion. Corneal sensitivity, which was diminished in contact lens wearers, recovered within 7 days after discontinuing contact lens wear.

Adolescent↗