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P Muñoz

Publications and source records attributed to P Muñoz.

At least 163 records · Page 9Linked to original sources

[Application of a system of serological surveillance of Chagas disease in a region of high chagasic endemia. I. Prevalence of Trypanosoma cruzi infection in Salamanca].

A serologic study for prevalence of Chagas infection was performed in Salamanca, Northern Chile. Indirect immunofluorescence and indirect hemagglutination reactions were used in samples from 1529 females and 698 males representing 10% of the population. A total of 499 positive results were obtained. The incidence of infection increases at a mean rate of 1% per year up to age 30, declining slowly in older groups to reach a maximum of 39.7% for the population. These data will be used to implement appropriate serologic surveillance programs and sanitary control measures in this and other populations.

Adolescent↗

[Epidemic outbreak of methicillin-resistant Staphylococcus aureus in a general hospital. Preliminary report].

The incidence of MRSA infections in Spain had remained in a low level through the years, being MRSA usually less than 1.5% of all S. aureus isolates. Since October 1988, we have detected in our hospital a MRSA outbreak. The epidemic started in the surgical wards, and spread through the rest of the institution. The incidence of cases was higher in the ICU's, areas that act as "multipliers" of the outbreak. In spite of standard control measures, the total number of patients with MRSA was 245 in April 1990. We studied prospectively a sample of 100 MRSA patients: thirty-six percent were colonized and 46% infected. The more common source of infection was the lower respiratory tract and primary bacteremia. The infection-related mortality was 30%. Our MRSA strain belong to phage type III, and shows a characteristic multiple antibiotic resistant pattern, the MRSA strain is sensitive to vancomycin, fusidic acid, phosphomycin and cotrimoxazole. Over the entire outbreak period, the MRSA strain developed resistance to rifampin, imipenem-cilastatin and ciprofloxacin. In spite of all control measures implemented, the outbreak can not have been totally controlled, and MRSA is now an endemic pathogen in our institution. Therefore, major changes in therapeutic approach to nosocomial infections have been since then introduced.

Adult↗

[Infectious complications in neutropenic patients with malignant hemopathies. A prospective study of 279 cases of neutropenia].

We prospectively evaluated the infective complications in 279 neutropenic episodes which developed during the treatment of 79 patients with malignant hemopathies over a 35 month period. In 150 episodes (53.73%) infections were detected: one infection in 121 episodes and two in 29 episodes. Overall 179 infections were detected. 75 of them (41.89%) were considered as possible, 57 (31.84%) were microbiologically documented with bacteremia/fungemia 24 (13.40%) were clinically documented, and 23 (12.84%) were microbiologically documented without bacteremia/fungemia. The portal of entry could not be identified in 121 infections (67.59%), 26 (14.76%) originated in the skin and soft tissues, 14 (7.82%) in the lung, 7 (3.91%) in the oropharynx, 5 (2.79%) in a catheter, and 6 (3.33%) were of miscellaneous origin. Of 80 microbiologically documented infections, 39 (48.75%) were due to gram-negative bacteria, 23 (28.75%) to gram-positive bacteria, 12 (15%) to fungi, and 6 (7.5%) to polymicrobial flora. The overall mortality rate was 4.3%. It was 8% for episodes complicated by infection and 0 in episodes of neutropenia without infection.

Bacterial Infections↗

[Mucormycosis. The disease spectrum in 13 patients].

Mucormycosis is an uncommon infection caused by fungi of the order Mucorales. During an 8-year period, mucormycosis was diagnosed in 13 patients from three Madrid hospitals. There were 8 males and 5 females, with ages ranging from 21 to 75 years (mean 45 years). There were several underlying diseases, and 4 patients had more than one. Five had diabetes mellitus, 4 chronic renal failure, 2 acute myeloblastic leukemia, 2 were narcotic abusers and were infected by the human immunodeficiency virus (HIV), 1 had non-Hodgkin's lymphoma, 1 was a carrier of a renal allograft and 1 had systemic necrotizing vasculitis. There were different clinical presentations: rhino-orbital in 3, paranasal in 2, cutaneous in 2, pulmonary in 2, primary cerebral in 2, rhinocerebral in 1, and peritoneal in 1. The diagnosis was made during the first week in 6 patients, in the second week in 4, and it was delayed for more than one month in 2. Fresh examination of clinical samples was carried out in 3 patients and hyphae were visualized in all 3. Cultures were taken in 10 patients and they were positive in 7. All isolates were identified as Rhizopus sp. One patient died within 24 hours without being treated, 12 were treated with amphotericin B and 9 received surgical therapy. Six patients (46%) died. The involvement of central nervous system and the absence of surgical therapy were associated with a poor outcome. These results indicate that mucormycosis can develop in several clinical contexts and has a varying clinical presentation. It is a potentially curable infections when early diagnosed and appropriately treated.

Adult↗

Fetal IgG specificities against Trypanosoma cruzi antigens in infected newborns.

A panel of Trypanosoma cruzi antigens produced by recombinant DNA techniques was used to analyze the IgM and IgG specificities present in sera from 22 mothers with chronic Chagas disease and their newborn infants. Ten of the newborns were congenitally infected and the other 12 children were healthy. While in most cases IgG specificities in the newborns mirrored those of their mothers, congenitally infected newborns had, in addition, IgG specificities that were undetectable in their mothers. The new IgG specificities observed most frequently were against a shed acute-phase antigen (SAPA), and less frequently, against other nine different parasite antigens. Thus, SAPA is able to identify new fetal IgGs because antibodies against this antigen are generated during the acute phase of the infection and not in their chronically infected mothers. Sera from congenital cases also had IgMs against several parasite antigens, but again, SAPA was the most frequently detected. Neither IgMs nor new IgG specificities were detected in healthy children born to mothers with Chagas disease. We conclude that individual antigens can be used to detect new IgG specificities present in the cord blood from infected newborns. Furthermore, detection of IgMs and new fetal IgGs with recombinant antigens may be used to sort out congenitally infected infants from uninfected ones, a method that might be applied to other infectious diseases.

Animals↗

Impact of the BACTEC NR system in detecting Candida fungemia.

As a result of the growing importance of candidemia, various techniques for the detection of Candida spp. in blood have been designed with a view to speeding up the laboratory procedure. We have performed a retrospective comparison of the efficiencies of the conventional VACUTAINER system (Becton Dickinson Vacutainer Systems) and the BACTEC NR system (Johnston Laboratories, Inc.). During a 4-year period, 88,300 blood cultures were processed, with growth of Candida species in 552. The mean times required for the detection of growth were 7.55 days with the VACUTAINER system and 4.1 days with the BACTEC NR system (P less than 0.05). During the first week of incubation, the VACUTAINER system detected 56.1% of the candidemias and the BACTEC NR detected 93.6% (P less than 0.05). Use of the BACTEC NR therefore permits reduction of the incubation period from the previously established 4 weeks to a more convenient 7 to 14 days.

Candida↗

[Multicenter study of fluconazole in the treatment of oropharyngeal candidiasis in immunodepressed patients].

We have evaluated the efficacy of fluconazole, 50 mg/day for 2 weeks, to treat oropharyngeal candidiasis in immunologically compromised patients. There were overall 27 patients, 25 of which were HIV+ and 2 had neutropenia. The rate of clinical response at the end of therapy, and one week and one month afterwards were 96%, 76% and 64%, respectively. The microbiological eradication was achieved in 36% of patients. The tolerance of the drug was satisfactory, although in 3 cases features of hepatic toxicity were detected. The convenience, good tolerance and clinical efficacy of fluconazole make it the therapy of choice for oropharyngeal candidiasis in immunologically compromised patients.

Adult↗

[One hour xylose test blood in the diagnosis of celiac disease].

Plasma levels of d-xylose one hr after a standard 5 g oral dose were measured in 82 children suspected of having celiac disease. Duodenal mucosa was obtained by intestinal biopsy in all. Among patients with normal mucosa, 95% had xylose levels above 20 mg/dl; 100% of patients with a flat mucosa had levels under 20 mg/dl. Results were independent of patients age. We conclude that this is a reliable test to screen patients suspected of having celiac disease, prior to intestinal biopsy.

Adolescent↗

Determination of acute toxic effects in mice following exposure to methyl bromide.

An inhalation system was designed and constructed for acute nose exposure of mice to methyl bromide. Animals were exposed for 1 h to concentrations ranging from 0.87 to 5.93 mg/l. Mice exposed to concentrations up to 1.72 mg/l did not exhibit any indication of developing a toxic response. Animals exposed to concentrations to 2.20 and 2.70 mg/l exhibited significantly decreased lung and liver weights when compared to controls. Animals exposed to concentrations above 3.50 mg/l exhibited kidney lesions. At concentrations of 3.82 mg/l and above, animals exhibited abnormal clinical signs, weight loss, and mortality. In addition, at 4.70 mg/l, a liver lesion was observed. At concentrations above 5.77 mg/l, pathological changes were observed in the color and a decreased motor coordination was evident. Methyl bromide exposures of up to 3.82 mg/l did not affect the ability of mice to recall a single-task passive-avoidance test. The 1-h LC50 of methyl bromide in mice via inhalation was determined to be 4.68 mg/l (approximately 1200 ppm). The dose-response curve was quite steep and the LC10 to LC90 range of mortality was contained within a doubling of concentration.

Animals↗