Biomedical subjects

V García

Publications and source records attributed to V García.

At least 37 records · Page 2Linked to original sources

PubMed2000

CCR5 and beta-chemokines in HIV-1 infected children.

The duration from initial infection with HIV-1 to CD4 lymphocyte depletion and progression to AIDS varies among infected individuals. Despite treatment with highly active antiretroviral therapy (HAART), patients still show different stages of disease progression. We examined the role of beta-chemokines and its receptor, CCR5 in HIV-1 infected children in order to define determinants of HIV progression among treated individuals. Population was divided in two groups: Group 1--Long Term Non Progressors (LTNP) includes 10 patients with B1-B2 CDC disease classification and with a less aggressive therapy (only 2 in HAART); Group 2--Rapid Progressors (RP) includes 9 patients with C3 disease classification. All the patients had a CCR5 wild type (wt) genotype indicating that they do not have the 32 base-pair deletion associated with slower progression. There was an increased production of MIP 1-beta in 8/10 LTNP but only in 4/9 Progressors (Paired t-test/Wilcoxon Sign test, p-value < 0.05). The change in the levels of MIP-1 beta after PHA stimulation was statistically significant in both groups. The levels of RANTES increased in LTNP and RP and the change of the levels after mitogen stimulation was statistically significant for both groups included. The production of RANTES and MIP-1 beta in response to stimulation between both groups was not statistically significant. The production of MIP-1 alpha was variable in both groups and the difference in the levels after mitogen stimulation between the groups was not statistically significant. These results suggest that beta-chemokines do not play an important role in HIV-1 progression in children undergoing HAART.

Chemokines, CC↗

PubMed1999

[Patient preference and stereotype about the gender of the family physician].

OBJECTIVE: To study the preferences of patients on the gender of the physician when consulting for particular health problems; and to know the gender stereotypes that patients assign to physicians. DESIGN: Cross-sectional study. SETTING: Five teaching health centres in Granada (Spain). PATIENTS: Randomised sample of patients that consulted 10 female and 20 female physicians during three months (17 patients per physician), for alfa = 5%, beta = 80%, to detect a difference of 12% between male and female physicians. MEASUREMENTS AND MAIN RESULTS: We used a questionnaire adapted from Fennema (Family Medicine Dept., Wisconsin University, 1990) that was administered by interviewers after the consultancy, following a previous pilot study. Preference and stereotype scales comprised 10 items, with five reponses (neutral mid-point). Differences were analysed with chi 2 with correction for continuity. Non-reponders (33%) were replaced, and their age and sex did not bias the study results. Responders were 210 males (40.9%) and 304 women (59.1%). For "flux in penis/vagina" and "haemorrhoids" 50-60% of the patients preferred a physician of the same sex, with the remainder expressing no preference. The women preferred female physicians for family problems (23%) and depression (23%). The male physicians were more often perceived to be unorganised than were the females (24% vs. 5%, p < 0.0005), while the female physicians were more often described as humane (15% vs. 10%, p < 0.0005). Characteristics expressing technical competence were more often attributed to the male physicians than to the females, while those expressing empathy were more often attributed to the female physicians. CONCLUSIONS: Patients prefer physicians of the same gender for some health problems and not for others. Patients assign gender stereotypes to physicians. These findings will permit a better interpretation of doctor-patient relationships.

Cross-Sectional Studies↗

PubMed1999

Analysis of risk factors associated with nosocomial bacteraemias.

A prospective study of 2676 blood cultures was performed to identify the factors associated with clinically, significant nosocomial bacteraemia that occurred during a one year period in the Malaga University Clinical Hospital. Three hundred and fifty-five episodes of bacteraemia were considered clinically significant. The overall incidence of bacteraemia was 19.5/1000 admissions, of which 46% were hospital-acquired. A multivariate model showed that only six factors were significantly, and independently, responsible for nosocomial bacteraemias: intravascular catheterization (P < 0.0001, OR = 18.37), invasive procedures (P < 0.0001, OR = 10.38), malignancy (P = 0.035, OR = 3.11), indwelling devices (P = 0.005, OR = 3.05), stay in intensive care or surgical departments (P = 0.05, OR = 2.63) and length of hospital stay (P = 0.051, OR = 1.02). These results show that the factors which had most influence on the development of nosocomial bacteraemias were those factors associated with the treatment received by patients during their hospital stay.

Adult↗

PubMed1999

[A universal method to correct underreporting of communicable diseases. Real incidence of hydatidosis in Chile, 1985-1994].

BACKGROUND: There is evidence to postulate that undernotification is the reason for the great decrease in the reported incidence of hydatidosis in Chile. AIM: To develop and propose a method to assess the notification of transmissible diseases, based on observed lethality and hospital discharges. MATERIAL AND METHODS: Human hydatidosis in the period 1985-1994 was used as a model to develop the method. Official reports and mortality were analyzed first, determining the first lethality rate. A second lethality rate was calculated based on hospital discharges and a third, based on all Chilean surgical series published in the last two decades. Adjusting official notification of lethality to the true lethality according to surgical series, the number of unreported cases was calculated and the true incidence of hydatidosis was calculated, summing these cases to the official notification. RESULTS: According to this method, the real rates of human hydatidosis in the period 1985-1994, would fluctuate between 6.5 and 11.4 per 100,000. This figure is four times higher than the official notification in the analysed period. CONCLUSIONS: The correction of under notification based on hospital discharges, with or without correction for repeated hospital admissions, or real mortality of surgical series gave similar results, suggesting that both methods are correct.

Chile↗

PubMed1998

Serotypes of Escherichia coli isolated from septicaemic chickens in Galicia (northwest Spain).

The purpose of this study was to establish the serogroups of Escherichia coli that cause avian colibacillosis in Spain. The serogroups of 625 avian E. coli isolated between 1992 and 1993 were determined. The 458 E. coli from chickens with septicaemia belonged to 62 different O serogroups; however, 59% were of one of 18 serogroups (O1, O2, O5, O8, O12, O14, O15, O18, O20, O53, O78, O81, O83, O102, O103, O115, O116 and O132). These 18 serogroups were also determined as an important percentage (29%) of control isolates from faeces of healthy birds. Nevertheless, a significant difference (59% versus 29%; P < 0.001) was observed. Furthermore, the serogroups O12, O14, O18, O53, O78, O81, O102, O115, O116 and O132 were almost exclusively identified among septicaemic E. coli (31% versus 3%; P < 0.001). The high prevalence of O18, O81, O115, O116 and O132 isolates was not expected and may indicate the emergence of five new serogroups associated with avian colibacillosis not yet reported.

Animals↗

PubMed1998

[Nutritional risk factors for gallstones. Epidemiological analysis].

This article reviews the role of nutrition in the incidence of gallstones. The epidemiological situation of gallbladder disease has wide worldwide geographical variations, being Pima Indians and the Chileans the most affected populations. The main nutritional risk factor is obesity. Other risk are serum cholesterol and triglyceride levels, unbalanced and excessive caloric intake, fasting periods of more than eight hours, hypocaloric diets of less than 700 Kcal/day, specially in obese subjects and parenteral nutrition lasting more than two weeks. The main conclusion of this revision is that nutritional behaviors of the population must be improved through public health programs, to reduce the incidence of obesity and related nutritional imbalances.

Chile↗

PubMed1998

[Radionuclide scan with TC-99m-tin colloid in the evaluation of orthopedic implant infections].

We have studied 26 patients (32-77 years old, 16 females) with suspicion of joint arthroplasty infection: 11 total hip replacements, 12 total knee replacements and 3 osteosinthesys. A bone scintigraphy with MDP-99mTc, a scintigraphy with HMPAO-WBC and a scintigraphy with 99mTc-stannous colloid were made in all patients. The final diagnostic was based in joint cultures and clinic and radiologic evolution of the patients. The earliest phase of the bone scintigraphy was positive in 18 patients. The later phase was positive in all them. The WBC was positive in 20 out of 26 patients. The bone marrow scintigraphy showed a congruent pattern with WBC in 18 patients (17 infected and 1 without infection). The other ones (8 patients) showed an incongruent pattern (7 with infection and 1 without it). The results show that the bone marrow scintigraphy with 99mTc-stannous colloid improves the accuracy of the diagnostic of bone prosthesis infection and should be included into the diagnosis protocol of this disease.

Adult↗

PubMed1998

[Effective renal plasma flow with I-131-hipuran: evaluation of a method with four extractions].

The aim of this work was to evaluate a method for the estimation of the effective renal plasma flow (ERPF) using sodium 131I-o-hippurate (OIH) by means the bicompartmental analysis of the radioactive concentration of 4 plasma samples, analyzing the error obtained respecting to the multi-sample method and comparing it with those obtained with other simplified methods. We calculated the ERPF from 62 patients using the multi-sample method as standard, the method based in a single sample at 44 minutes p.i., a method based in 2 samples from the first exponential, 4 methods based in 2 samples from the second exponential, one method based in 3 samples and 5 methods based in 4 samples (2 from the first exponential and 2 from the second exponential). Each simplified method was compared to the standard method and their absolute error (AE) and standard estimation error (SEE) were calculated. The method based in the 4 samples withdrawn at 4, 10, 30 and 60 minutes p.i. was the best of them with a correlation factor with the standard equal to 0.997, an EA that ranged from -63 ml/min to 49 ml/min (mean: -4 ml/min) and a SEE of 19.5 ml/min.

Body Fluid Compartments↗

PubMed1998

[Audit of deaths due to cervical cancer in a health service of Santiago. A preliminary analysis].

BACKGROUND: Despite the epidemiological importance and the surveillance programs to detect cervix uterine cancer in Chile, its mortality continues to be high. AIM: To perform an audit of all deaths due to cervix uterine cancer, that occurred in a health service of Santiago during 1995. MATERIAL AND METHODS: The clinical records and pathological studies of 46 women, whose death certificates indicated cervix uterine cancer as the cause of death, were audited. RESULTS: In six women, the audit revealed that the cause of death was not a cervix uterine cancer, and they were discarded from further analyses. The higher mortality rate (36/100,000) occurred in women over 64 years old, those living in the poorest community and with less Papanicolaou vaginal smears coverage (La Pintana). The evolution prior to diagnosis was registered in only four women and was of less than one year. Most women consulted in advanced stages of the disease and only 48% were subjected to some sort of treatment (surgery, radiotherapy or chemotherapy). Mean survival was 3 years and mean age at death was 55.5 years old. There was a great lack of clinical and epidemiological information. In only 13 women information about previous Pap smears was registered. CONCLUSIONS: Audit of deaths should be an important component of preventive programs for cervix uterine cancer, and the coverage of Pap smears should be improved.

Adult↗

PubMed1998

[Fungemia in patients with HIV infection].

OBJECTIVE: To make an analysis of fungemia in HIV-infected patients in our hospital. PATIENTS AND METHODS: We retrospectively (1989-1997) studied all HIV-infected patients with positive blood cultures for Candida sp., Cryptococcus neoformans or any other fungal infection. RESULTS: C. neoformans was isolated in 11 patients (10 men and 1 woman): Six were treated with amphotericin B and 5 with fluconazole. 2 patients died during the acute phase and the infection relapsed in 3. Blood culture for Candida sp. were positive in 9 (8 men and 1 woman): only a case was nosocomial. Seven patients were intravenous drug users and the presenting manifestations were autolimited candidemia in 3, aortic and tricuspid endocarditis in 1 and 2 cases respectively and pneumonia in another one. Six C. albicans, 2 C. krusei and 1 C. glabrata were isolated. 3 patients received amphotericin B and 3 received fluconazole. 2 patients suffering from endocarditis died and so did the patient with C. glabrata infection. A patient, who denied having travelled to endemic areas, developed histoplasmosis; blood culture was positive for H. capsulatum. He initially had a good response to amphotericin B and itraconazole. CONCLUSIONS: Fungemia is not frequent in HIV-infected patients. Cryptococcosis and histoplasmosis occur in advanced HIV-patients and candidemia is fundamentally associated with intravenous drug use.

Adult↗

PubMed1998

[Focal nodular liver hyperplasia of atypical presentation].

Focal nodular hyperplasia is a benign hepatic tumor that usually appears in young women. Diagnosis of focal nodular hyperplasia is often incidental when an ultrasonography or computed tomography is performed by other reasons, because its course is generally asymptomatic; the presence of a central fibrous scar is characteristic. Management in focal nodular hyperplasia must be conservative, with ultrasonographic follow-up, and it only must be treated when patients are symptomatics or in case of tumoral enlargement. We report a case of FNH in which symptomatic presentation and the absence of central stellate scar in ultrasonography, computed tomography and magnetic resonance leads to a misdiagnostic of hepatic adenoma, that conditioned a surgical resection. The later examination was diagnostic of focal nodular hyperplasia.

Adenoma↗

PubMed1996

Intramammary immunization with live-attenuated Staphylococcus aureus: microbiological and immunological studies in a mouse mastitis model.

Mammary infection was induced in lactating mice by intramammary injection of Staphylococcus aureus. Histopathological analysis revealed infiltration and lesions of varying magnitude that were still apparent 21 days after the challenge. Concomitantly, viable S. aureus was recovered from infected mammary glands. Mice were immunized by the intramammary route with 5 x 10(6) colony forming units of a temperature-sensitive mutant of S. aureus and subsequently received a boosting injection seven days later. On day 14 mice were challenged by the intramammary route with the wild-type strain. Intramammary immunization induced a significant increase in milk IgA (P < 0.05), serum IgG (P < 0.05) and serum IgA (P < 0.05) on the day of the challenge, when compared with non-immunized mice. Immunization decreased significantly (P < 0.01) the number of S. aureus colony forming units recovered 96 h after intramammary challenge. In conclusion, the feasibility of immunizing locally with temperature-sensitive S. aureus to induce immunity in the mouse mammary gland was demonstrated. The mouse model of mastitis is proposed as a useful system for screening temperature-sensitive S. aureus strains to be utilized in the development of a vaccine.

Animals↗

PubMed1996

[Splenic infarction].

A 53-year-old male suffered splenic infarction etiologically related to atrial fibrillation and non-obstructive hypertrophic cardiomyopathy. The main clinical manifestations were a one-month history of epigastric and left upper quadrant pain, with tenderness to palpation in the later zone. Laboratory tests revealed a slight leucocytosis (14.700) with left shift and a marked increase in LDH concentration (945 IU). Abdominal CAT and arteriography established the diagnosis, Echography proved normal. Patient evolution was satisfactory with conservative medical treatment. We conclude that splenic infarction should be considered in all cases of acute or chronic pain in the left hypochondrium. The diagnosis is established by CAT, arteriography and hepatosplenic gammagraphy. Medical management is initially advocated, surgery being reserved for those cases involving complications or in which diagnosis is not clear. Emphasis is placed on the main etiological, clinical, diagnostic and management characteristics of splenic infarction.

Angiography↗

PubMed1995

[A case of Prune Belly Syndrome. Prenatal diagnosis].

Prune Belly Syndrome is a rare and complicated condition affecting the genitourinary organs and abdominal wall, it was named after the aspect of the abdomen after the bladder has been drained. In its fully developed form presents with the triad: megalocyst, abdominal muscle deficiency and cryptorchidism. We present a case of a patient with 22 weeks of gestation with ultrasonographic diagnosis of a large thoracoabdominal cyst. The delivery was by cesarean operation. We analyzed the literature.

Abnormalities, Multiple↗

PubMed1995

[Surgical risk assessment using multivariate analysis].

INTRODUCTION: Over and above the risk of a disease itself, surgical treatment implies additional risk involving possible temporary or permanent deterioration in a patient's health. Most studies of anesthetic-surgical risk are based on mortality or serious morbidity (severe, permanent deterioration). They may therefore be of limited applicability in hospitals where such outcomes are rare due to the types of patients treated. In order to compare and classify patients as well as improve outcome in such health care settings other parameters must be evaluated. PATIENTS AND METHODS: Indicators presaging adverse situations related directly to surgery in our postoperative intensive care units involve blood transfusion and perioperative events. By applying multivariate (regression) analysis we can determine the factors that condition these unfavorable situations. RESULTS: In the setting we studied, the main determinants of unfavorable events after surgery are patient health as shown by ASA classification, duration of operation and type of surgery. CONCLUSIONS: 1) Peripheral surgery in patients in good health is very safe. 2) Easily obtained parameters can be used to obtain a fairly efficient prediction of risk. 3) Single-setting risk studies are easy to carry out and useful for providing information about a specific hospital center.

Adolescent↗

PubMed1994

[Asymptomatic bacteriuria and pyuria during pregnancy].

BACKGROUND: The presence of pyuria and the role of mixed culture in the diagnosis of asymptomatic bacteriuria in pregnant women have been evaluated METHODS: One hundred and sixty four pregnant women without any symptomatology have been studied using two cultures of mid-stream urine samples and pyuria quantification. In addition culture of bladder urine has been carried out in 17 of these patients (12 with pure cultures and 5 with mixed cultures). RESULTS: 110 samples were culture negative without pyuria; 7 were pure cultures with pyuria; 19 pure culture without pyuria and the remaining 28 patients yielded mixed culture with or without pyuria in the first culture. Twenty of these 28 mixed cultures were negative in the second culture. A estimated frequency of asymptomatic bacteriuria in pregnancy was 16% and pyuria was only found in 27% of pregnant women with asymptomatic bacteriuria. CONCLUSION: The pyuria is not a useful marker for the diagnosis of asymptomatic bacteriuria in pregnancy.

Bacteria↗

PubMed1993

[Long-term results of endoscopic sphincterotomy].

A review is made of the results of long-term endoscopic sphincterotomy. We studied 81 endoscopic sphincterotomies performed between 1980 and 1985. The technique performed, its indications and immediate complications were evaluated, along with the follow-up carried out in these patients (minimum 6 years). In view of the results obtained, the patients were classified as asymptomatic or symptomatic. Thus, immediate complications (21.9%) were all minor, with the exception of one case (1.2%) of severe complication due to acute pancreatitis. One death was recorded three days after sphincterotomy, corresponding to an elderly patient with in situ gallbladder as a consequence of biliary sepsis. In turn, 91.4% of the patients followed-up at long term remained asymptomatic. The overall results show the method to be effective, with few either immediate or long-term complications.

Adult↗

PubMed1992

[Syncope as presentation form of pulmonary thromboembolism. Study of 15 cases].

BACKGROUND: To evaluate the prevalence of syncope as a form of presentation of pulmonary thromboembolism (PTE) in the emergency department of a general hospital. METHODS: All the cases of PTE having gone to the emergency department between May 1983 and July 1989 were collected. A radiography of the thorax, arterial gasometry, an electrocardiogram and a pulmonary perfusion scintigraphy were performed in each patient. Ventilation scintigraphy and/or pulmonary DIVAS were also carried out when necessary. RESULTS: Of a total of 63 patients, 15 (24%) had a syncope as a primary manifestation. No significant differences were observed in regards to predisposing factors between the syncope group (S) and the non-syncope group (NS) with there being a predominance of women in the S group (p less than 0.05). Furthermore, the S group had a greater prevalence of tachycardia, hypotension, electrocardiographic changes, pleural effusion and perfusion defect greater than 50% in the pulmonary scintigraphy. CONCLUSIONS: PTE should be discarded in any patient with a clinical picture of syncope with hypotension and tachycardia, especially if female. When PTE is presented as a syncope it is generally a massive embolism.

Adult↗