PubMed Health⌕ Search

Biomedical subjects

R Comet

Publications and source records attributed to R Comet.

18 recordsLinked to original sources

Pancoast's syndrome secondary to lung infection with cutaneous fistulisation caused by Staphylococcus aureus.

Apical bronchial carcinoma is the most common cause of Pancoast's syndrome. Of the many other causes reported, infection is a rare one. A literature review is presented and a case of Pancoast's syndrome, secondary to apical lung pneumonia with bronchocutaneous fistulisation caused by Staphylococcus aureus infection, is reported. Clinical and radiological resolution was achieved after treatment with antibiotics.

Bronchial Fistula↗

Four-day, twice daily, quadruple therapy with amoxicillin, clarithromycin, tinidazole and omeprazole to cure Helicobacter pylori infection: a pilot study.

BACKGROUND: The best regimen for the treatment of Helicobacter pylori infection has yet to be defined. Four-day quadruple therapy with tetracycline, metronidazole, bismuth, and a proton pump inhibitor has been shown to obtain a very high cure rate. However, the fact that it must be taken four times daily may interfere with compliance. The objective of the study was to test the efficacy and tolerability of a new 4-day therapy with 4 drugs taken every 12 hours to cure H. pylori infection. Patients and Methods. Fifty-six consecutive patients with peptic ulcer disease and H. pylori infection were treated with an oral 4-day course with omeprazole (20 mg/12 hours), clarithromycin (500 mg/12 hours), amoxicillin (1 g/12 hours) and tinidazole (500 mg/12 hours). Efficacy of the treatment was determined at least 2 months after therapy either by biopsy (in the case of gastric ulcer) or by 13C-urea breath test. A second breath test was performed at least 6 months after therapy. RESULTS: Two patients were lost to follow-up. Forty-nine of the remaining 54 patients were cured at the first control [intention-to-treat cure rate: 87.5% (CI 95% 75-94%); per protocol cure rate: 90.7% (CI 95% 81-98%)]. Forty-three of these 49 cured patients returned for a second 13C urea breath-test at 6-12 months. Two of them were not cured, giving a long-term cure rate of 85.5% per protocol and 73.2% by intention-to-treat. Compliance was good, although 25 patients had mild side effects. CONCLUSION: This particular four-day therapy is well tolerated, easy to follow, and achieves an acceptably high cure rate.

Adult↗

[Pulmonary hypoplasia in adults: embryology, clinical presentation and diagnostic methods. Our experience and review of the literature].

We report five patients diagnosed of pulmonary hypoplasia (PH) in adulthood (age > 18 years, range 45 to 67 years). PH was left-sided in four cases. The malformations found were 2 cases of renal agenesis, 2 diaphragmatic hernias and 1 hiatal hernia. Lung function data were FEV1 0.88 +/- 0.32 L; FVC 1.30 +/- 0.52 L; FEV 1/FVC 68.5 +/- 5%. Arterial gases (with FiO2 0.21) were PaO2 63.6 +/- 24 and PaCO2 47.1 +/- 11.2 mmHg. Three cases were referred for monitoring of respiratory insufficiency (2 requiring home oxygen therapy) and two for radiographic study of chest disease. The diagnoses were made by computerized tomography (CT) of the chest. Congenital diseases due to underdeveloped lungs in the pseudoglandular phase are rarely diagnosed in adults (48 cases, including ours, have been found in the literature), and PH is rarely diagnosed, possibly because the anomalies observed are attributed to old infections. Clinical presentation is highly variable, depending in large measure on a history of smoking and repeated respiratory infections. Chest CT is at present the diagnostic tool of choice.

Aged↗

Two-day quadruple therapy for cure of Helicobacter pylori infection: a comparative, randomized trial.

OBJECTIVE: We sought to compare a 2-day quadruple therapy with a 14-day triple therapy in the treatment of Helicobacter pylori infection. METHODS: Eighty-one consecutive patients with an endoscopically diagnosed peptic ulcer and demonstrated infection by H. pylori were included in the study. Patients were randomized to receive omeprazole 40 mg b.i.d., amoxicillin 2.5 g once daily, metronidazole 500 mg t.i.d., and bismuth subcitrate 360 mg t.i.d. for 2 days, followed by omeprazole 20 mg once daily for 6 additional days (Group 1) or a 14-day course of omeprazole 20 mg b.i.d., amoxicillin 1 g t.i.d., and metronidazole 500 mg t.i.d. (Group 2). Eradication was evaluated by antral biopsy and rapid urease test at 2 months after therapy and by C13-urea breath test after a year. RESULTS: Two patients were lost to follow-up at 2 months. Intention-to-treat analysis showed that H. pylori infection was cured in 29 of 42 patients (69%; 95% CI: 53-82%) in Group 1 versus 36 of 39 (92%; 95% CI: 78-98%) of patients in Group 2 (p = 0.009). Per-protocol analysis showed a cure rate of 71% (95% CI: 55-84%) (29/41 patients) and 95% (95% CI: 81-99%) (36/38 patients), respectively (p = 0.007). Fifty-five of 65 cured patients returned 1 year after treatment (26 in Group 1, 29 in Group 2). All but one in Group 2 remained cured. There were no significant differences in compliance (88% in Group 1 versus 92% in Group 2) or in the presence of side effects (27%; 95% CI: 15-43% versus 41%; 95% CI: 26-58%; ns). CONCLUSION: Two-day quadruple therapy is significantly less effective than 2-wk triple treatment.

Adolescent↗

[Seven-day omeprazole, clarithromycin, and amoxicillin for the therapy of Helicobacter pylori infection].

BACKGROUND: There are few series reporting efficacy of seven-day therapy with omeprazole, amoxicillin and clarithromycin for cure of Helicobacter pylori infection in Spain. The aim of the present study was to evaluate the efficacy of this treatment to eradicate H. pylori infection. PATIENTS AND METHODS: One hundred consecutive patients with peptic ulcer disease and H. pylori infection were evaluated for eradication therapy between January and November 1996. Four of them were excluded because of reported penicillin allergy. The remaining 96 patients received a seven days course of omeprazole 20 mg/12h, clarithromycin 500 mg/12h and amoxicillin 1 g/12h. The efficacy of the treatment was evaluated at 2-4 months after therapy either by endoscopic biopsy or by 13C urea breath-test. RESULTS: Seventy-eight patients were found to be cured at the control evaluation. Intention to treat analysis showed a cure rate of 81.3% (95% CI: 74-89%). Per protocol analysis showed a cure rate of 85.7% (95% CI: 79-93%)--78 out of 91 patient who returned for follow-up-. Compliance with the treatment was good in 94.5% of patients. Five patients presented mild side effects (diarrhea, abdominal pain, oral candidiasis and metallic taste). None of them had to interrupt the treatment. CONCLUSION: Seven-day therapy with omeprazole, amoxicillin and clarithromycin achieves a 85% cure rate of H. pylori infection in our area.

Aged↗

[CT in radiation enteritis].

The computed tomography findings of 18 patients who had received radiation therapy for pelvic malignancies were reviewed retrospectively. They include bowel wall thickening, mainly in central areas and in contact with anterior abdominal wall, mesenteric thickening, without masses and rectal and presacral space involvement. The differential diagnosis of these findings is discussed.

Adult↗

Psoas muscle pancreatic pseudocyst: CT--US diagnosis and percutaneous drainage.

We present 2 cases of psoas muscle pancreatic pseudocysts. In both cases there was no clinical or laboratory evidence of recent acute pancreatitis. The route of extension for the pseudocyst from the pancreas to the psoas was the perirenal space. In both cases the diagnosis was made on the basis of imaging studies and the pseudocysts resolved with percutaneous drainage only.

Abdominal Muscles↗

[Pregnancy-specific beta-1 glycoprotein (SP1) as a marker for tumors with or without trophoblastic character].

The pregnancy specific beta-1-glycoprotein (SP1) was measured by radioimmunoassay in 854 persons (control group 103, non-tumoral diseases 212, germinal tumors 30, and non-germinal tumors 509). Amounts higher than 2.5 ng/ml (upper normal limit) were observed in 35 cases with non tumoral diseases (specially chronic liver diseases), 97 of the non-germinal tumors (specially mammary, respiratory and digestive tumors), and 10 of the germinal tumors (pure and mixed choriocarcinomas, and embryonic carcinoma with yolk sac component). SP1 rarely is higher than 5 ng/ml in non-tumoral diseases and non-germinal tumors, while it is higher than 5 ng/ml in germinal tumors. SP1 is a good marker for trophoblastic neoplasms and shows a correlation with HCG-beta.

Age Factors↗

[Creatine phosphotransferase, B subunit, as a tumor marker. Preliminary results].

Creatine kinase B (CK-B) was evaluated as a tumor marker by radioimmunoassay determination of the isoenzyme in 518 persons (control group, malignant tumors, and several other diseases). Amounts higher than 8 ng/ml (upper normal limit) was observed in 12.6 per 100 of the digestive tumors, 6.1 per 100 of the mammary tumors, 37.7 per 100 of the respiratory tumors, and 22.2 per 100 of the prostatic tumors. A relation exists between CK-B and sigmoid flexure, liver, pancreas and esophagus tumors, between CK-B and acid phosphatase in prostate tumors, and between CK-B and evolution of digestive tumor. The determination of CK-B is useful in the case of tumors lacking known tumor markers, and also as a complementary sign in the diagnosis and evolution of sigmoid flexure and prostate neoplasms.

Adolescent↗