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N Martí

Publications and source records attributed to N Martí.

9 recordsLinked to original sources

Routine use of Gen-Probe Amplified Mycobacterium Tuberculosis Direct (MTD) test for detection of Mycobacterium tuberculosis with smear-positive and smear-negative specimens.

SETTING: Nucleic acid amplification tests, such as the Amplified Mycobacterium Tuberculosis Direct (MTD) Test, may improve early diagnosis of tuberculosis when used in combination with acid-fast bacilli smear examination with a similar turnaround time. OBJECTIVE: To evaluate the routine use of MTD in respiratory and non-respiratory samples; to investigate the improvement of MTD specificity and positive predictive value by defining an equivocal zone for result interpretation. DESIGN: MTD was performed according to the instructions supplied by the manufacturer. An equivocal zone was included for interpretation of results. Discordant results with culture were resolved by incorporating clinical data and multiple specimen analysis. RESULTS: The overall sensitivities, specificities, and positive and negative predictive values for respiratory specimens (n = 3308) were 90.8, 99.9, 99.1, and 99.2%, respectively. With extra-pulmonary specimens (n = 1350) those values were 67.4, 99.9, 98.2, and 97.9%, respectively. By implementing an equivocal zone, the specificity and positive predictive value of MTD were improved (from 99.1% and 88.6% to 99.9% and 98.9% respectively) without significantly altering other performance characteristics. CONCLUSIONS: Amplification assays cannot yet replace the conventional diagnostic techniques. Nevertheless, MTD is a reliable method for the direct detection of M. tuberculosis in clinical specimens. The number of false-positive results can be limited by defining an equivocal zone.

False Negative Reactions↗

[Analysis of experience in an integrated program of hospital rheumatological service and primary care].

BACKGROUND: In order to improve the health quality at the Primary care level, the Catalonian Health Authority (Servei Catala de la Salut) has begun a reform of the medical and surgical specialties. In this reform process the Hospital del Mar, Barcelona, Spain, has taken part in the incorporation of several medical and surgical hospital specialists to primary care within its influence area. In this study, we describe the results of the collaboration between Hospital health care and Primary care on rheumatic complaints during one year. METHODS: We carried out a descriptive study of some clinical and epidemiological variables of the population visited during one year (1995), at the Primary care level by the Rheumatologist. Our area has a population of 90,612 people, and its located in Barcelona City, Ciutat Vella Variables of study were collected during the period of time between January and December 1995. The following variables were recorded: age, gender, referral cause, rheumatologic diagnosis, intra-articular and peri-articular corticosteroid injections perform, techniques used for the diagnosis of rheumatic disease, follow-up level Data were statistically analyzed. RESULTS: Visits performed were 2,668 on 1,384 patients. Fifty-two percent were first visits, 48% were follow-up visits (Ratio first visits Nolfow-up visits: 0.57). Fifty-one percent of the patients were > 65 years old. Unspecific polyarthralgias, chronic low back pain, gonalgia and pathology of the shoulder were the most frequent complaints (> 50%). Osteoarthritis and soft-tissue diseases were the most frequent diagnosis with a percentage of 41% and 30.7%, respectively. Connective tissue diseases and spondyloarthropathies had account for 3.8% of global diagnosis. X-ray film has been the commonest technique used for the diagnosis of rheumatic diseases (80.5%). The waiting list for first visit initially has been 5 weeks, and at the end of study it has been 3 weeks. Ten percent of patients had been referred to the Hospital. CONCLUSIONS: Collaboration between Hospital care rheumatology and Primary care, improves the diagnostic quality, as well as it decreases the waiting list and allows the patients' control at the most appropriate care level.

Adolescent↗

[Favorable response to corticoid therapy in a patient with transverse myelitis in systemic lupus erythematosus].

Transverse myelitis is one of the most unusual neurologic complications of systemic lupus erythematosus. Its pathogenetic mechanisms are controversial. Several therapeutic regimens have been attempted with contradictory results. Corticotherapy appears to improve prognosis, although some authors question its beneficial effects. The case of a patient with systemic lupus erythematosus and transverse myelitis, who presented a favourable clinical course following early treatment with high-dose corticoids, is reported.

Administration, Oral↗

[Spinal cord ischemia indicating aneurysm of the abdominal aorta. Report of three cases].

We report 3 cases of dorsal ischemic myelopathy indicative of aneurysm of the abdominal aorta. In 2 cases the aneurysm was dissecting and in all patients medullary symptoms were preceded by sudden lumbar or abdominal pain. Neurological symptoms were slightly different in each case. One patient experienced 3 episodes of acute paraparesis and rapid regression evoking transitory medullary ischemic accidents (intermittent medullary claudication). Another patient suffered progressive asymmetric paraparesis which first stabilized and later improved partially after surgical treatment of the aneurysm. The third suffered acute paraplegia related to irreversible ischemia of the anterior 2/3 of the medulla. The great variety of clinical manifestations of spinal cord ischemia related to aneurysms of the descending aorta can be explained by the topography of the aneurysm, pecularities of medullary vascularization and, especially, by the diversity of etiopathogenetic mechanisms that give rise to ischemia. We conclude that in the face of symptoms suggesting dorsal ischemic myelopathy, the possibility that an aneurysm of the abdominal aorta may be the cause must be considered, whether or not pain has been experienced prior to signs of medullary involvement.

Aged↗

Treatment of respiratory infections with fosfomycin.

Results are presented for a series of 29 patients, 14 males and 15 females, with serious respiratory infections, in which fosfomycin proved effective. In all cases the study was completed by bacteriological, clinical, radiological and analytical controls. The average dose was 6 g/day (3 g orally and 3 g intramuscularly) for 1 or 2 weeks. The four isolated were P. aeruginosa, E. coli, Klebsiella-Enterobacter and D. pneumoniae. Overall sensitivity percentages were best for fosfomycin, gentamicin and colistin. Of the 29 germs isolated, only one strain of P. aeruginosa became resistant: this represents 3% resistance development. No side effects of intolerance or signs of hepatorenal insufficiency were observed during the treatment. Of the 29 patients treated, 22 were clinically cured, denoting 76% success.

Anti-Bacterial Agents↗