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V Asensi Alvarez

Publications and source records attributed to V Asensi Alvarez.

6 recordsLinked to original sources
PubMed2000

[Postsurgical meningitis caused by Pseudomonas aeruginosa: study of 15 cases and review of the literature].

OBJECTIVE: Pseudomonas aeruginosa meningitis is a rare condition which is usually associated with pathology in the ORL field, neurosurgery or local neurologic manipulations. The characteristics, epidemiology, and course of this entity were determined. METHODS: Fifteen episodes of nosocomial postsurgical Pseudomonas aeruginosa meningitis occurred between 1989 and 1996 were retrospectively analyzed. RESULTS: A previous cranioencephalic trauma was recorded in 46.6% of patients. The portals of entry included: intraventricular catheter (IC) (12 cases), CSF fistula (2 cases), and craniotomy (1 case). In five occasions (41.6%) the microorganism was also recovered from the intraventricular catheter. Once culture results were available, therapy with active drugs against Pseudomonas was instituted and in 7 occasions was accompanied by the removal of IC. Eight patients eventually cured and two patients relapsed. The absence of cure was significantly associated with non-removal of the IC (p < 0.01). The infection resulted in death in 26.6% of patients. CONCLUSIONS: Postsurgical Pseudomonas aeruginosa meningitis is an entity of growing relevance. It is associated with relevant morbi-mortality. Catheter removal is essential to obtain a favorable outcome.

Adolescent↗
PubMed1997

[Pyogenic hepatic abscess. Review of 59 cases and experience with imipenem].

OBJECTIVES: To study the different etiopathogenic, microbiological, clinical, evolutive, and therapeutic aspects in patients with pyogenic liver abscesses, with a special emphasis in the usefulness of imipenem-cilastatin therapy. MATERIALS AND METHODS: The clinical records of 59 patients with liver abscesses (45 single abscess and 14 multiple abscesses) diagnosed at our institution in the last eleven years were studied. RESULTS: The most common predisposing conditions included biliary (35.6%) and colon (15.3%) diseases, and abdominal trauma (15.3%). The microorganisms responsible for these abscesses included E. coli, Bacteroides spp., and different streptococci. CT and/or abdominal echography were the diagnostic techniques most commonly used. Twenty-three patients were treated with percutaneous drainage and antibiotics, 22 with surgical drainage and antibiotics, 6 with both types of drainage and antibiotics, and 8 exclusively with antibiotics. Twenty-three patients received imipenem (1 g/IV/8 h) and 29 other antibiotics. Twelve patients died and 9 required admission at the ICU. With regard to patients treated with imipenem, 17 (73.9%) cured, 3 of them (one single abscess and two multiple abscesses) without drainage. Two patients treated with imipenem (8.7%) and 4 treated with other antibiotics (13.8%) relapsed. CONCLUSIONS: Imipenem can be a useful antibiotic in association with percutaneous or surgical drainage for the treatment of pyogenic liver abscesses.

Adolescent↗
PubMed1995

[Native valve endocarditis caused by Staphylococcus aureus and streptococci. A comparative study].

OBJECTIVE: To know the validity and current prognosis of clinical prototypes assigned to streptococcal endocarditis (STREPEND) and Staphylococcus aureus endocarditis (SAE). PATIENTS AND METHODS: Fifty-four patients with SAE were compared with 43 patients with STREPEND diagnosed from 1984 to 1994 following a retrospective cohort study model. RESULTS: The incidence of SAE and STREPEND was 0.21 and 0.17, respectively, per 1,000 hospital admissions. The acquisition of community endocarditis (non drug abusers vs. drug abusers) and nosocomial endocarditis was 74% (31% vs. 43%) and 26% for SAE; the corresponding values for STREPEND: 89% (70% vs. 19%) and 11%, respectively. The overall mortality rate for STREPEND/SAE was 9%/26% (among drug abusers there were no fatalities recorded), whereas in non drug abusers the mortality rate reached 41% and for nosocomial forms 36%. SAE was independently associated with drug abuse habits, right-sided heart infection, development of embolism and a high mortality rate. In contrast, by means of the multivariant analysis, STREPEND was independently associated with a subacute onset form, left-sided heart infection, cardiac surgery, and a low mortality rate. CONCLUSIONS: Traditional stereotypes of the two main etiologies for endocarditis are still valid, although at present it is important to differentiate nosocomial endocarditis and in non drug abusers. Chemoprophylaxis compliance is low for STREPEND: Given the poor prognosis of SAE at the left heart side a more aggressive surgical attitude would be warranted.

Adult↗
PubMed1992

[Immunological changes in chronic osteomyelitis].

We have studied several aspects of cellular and humoral immunity in 19 patients with chronic osteomyelitis (CO) compared with 11 healthy controls of similar characteristics. Patients with CO showed significantly higher values of GSR, reactive protein C (RPC), IgG and lymphocytes CD3+ and lower values of the CD4+/CD3+ ratio, as well as an hypoergic response to 7 antigens in the different cutaneous hypersensibility tests, compared with healthy controls. The rate of "in vitro" blastic stimulation by different lectins was significantly lower in the group of patients, compared with controls. These changes in the cellular immunity are not correlated with the extent, chronicity and prognosis of the disease, although we did not performed sequential studies of the immunitary condition. None of these immunological markers seem to be a better predictor of the bone infectious activity than the traditional GSR or RPC.

Adult↗