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X Corbella

Publications and source records attributed to X Corbella.

At least 37 records · Page 2Linked to original sources
PubMed1996

[Estimation of costs attributable to nosocomial infection: prolongation of hospitalization and calculation of alternative costs].

BACKGROUND: Nosocomial infection represents a prolongation of hospital stay and an increase of costs. The aim of the study was to estimate attributable costs by means of two methods: calculation of costs resulting from an increase of hospital stay and calculation of costs attributed to services. METHODS: A matched case-control study was carried out with a cohort population. An appropriate control was found for 63 patients with surgical site infection, for 30 patients with respiratory infection and for 55 with urinary infection. The estimation of costs attributable to services includes the case-control pairs with surgical site infection and was performed of the sum of costs of diagnostic and therapeutic services rendered in the care of the surgical site infection. RESULTS: The median of postoperative stay was 21 days for cases with surgical site infection vs 10 days for controls (p < 0.001); the median length of stay was 21.5 days for cases with respiratory infection vs 11.5 days for controls (p < 0.01); and for urinary infection the median length of stay was 21 days for cases vs 15 days for controls (p < 0.01). The surgical site infection cost attributed to extra days was 310,310 pesetas and the surgical site infection cost attributed to service cost was 220,546 pesetas. CONCLUSIONS: Nosocomial infection produces a increase median hospital stay of 7-10 days. In absence of a precise accounting system, the prolongation of hospital stay was considered as the more objective date to estimate the costs.

Adolescent↗
PubMed1996

Relevance of digestive tract colonization in the epidemiology of nosocomial infections due to multiresistant Acinetobacter baumannii.

Fecal colonization with multiresistant Acinetobacter baumannii was evaluated in 189 consecutive patients in intensive care units (ICUs) during two different 2-month periods (October-November 1993 and May-June 1994). Rectal swabs were obtained weekly from admission to discharge from the ICU. Overall, 77 patients (41%) had multiresistant A. baumannii fecal colonization; colonization was detected in 55 (71%) of the patients within the first week of their ICU stay. Clinical infections due to multiresistant A. baumannii occurred more frequently in patients with fecal colonization than in those without fecal colonization (26% vs. 5%, respectively; P < .001). The reinforcement of isolation measures between study periods reduced both the number of fecal carriers of multiresistant A. baumannii (from 52% to 31%; P < .01) and the number of patients with multiresistant A. baumannii infections (from 17% to 11%; no statistical significance). The digestive tract of ICU patients could be an important epidemiologic reservoir for multiresistant A. baumannii infections in hospital outbreaks. Further prospective studies should be undertaken to define the relative significance of digestive tract colonization compared with other body site colonizations.

Acinetobacter↗
PubMed1995

Bacteremia due to viridans streptococci that are highly resistant to penicillin: increase among neutropenic patients with cancer.

We prospectively studied 260 episodes of bacteremia that occurred over a 6-year period in neutropenic patients with cancer. Twenty-three episodes were caused by viridans streptococci. Thirteen (57%) of these strains were penicillin-resistant (MICs of penicillin ranged from 0.25 micrograms/mL to 8 micrograms/mL). Ten of the 13 penicillin-resistant strains (77%) were highly resistant to penicillin (MIC, > or = 4 micrograms/mL). Rates of bacteremia due to highly penicillin-resistant viridans streptococci increased significantly from zero episodes per 1,000 admissions in 1987 to 17 episodes per 1,000 admissions in 1992 (P = .003). In a comparison between penicillin-resistant and penicillin-susceptible viridans streptococci bacteremia, the administration of beta-lactam antibiotics during the previous 2 weeks was the only factor significantly associated with penicillin-resistant cases: 9 (69%) of 13 patients with penicillin-resistant bacteremia had received beta-lactams vs. 2 (20%) of 10 patients with penicillin-susceptible bacteremia (P = .036). These findings may have significant clinical implications in the choice of both antimicrobial prophylaxis and empirical antibiotic regimens.

Adult↗
PubMed1995

Hypersensitivity hepatitis due to pyrazinamide.

Pyrazinamide hepatotoxicity is considered secondary to a direct and dose-related toxic effect. At currently used doses, pyrazinamide provides effective short-term treatment and is free from serious side effects. We report a case of pyrazinamide-induced hepatitis for which the rechallenge data strongly suggest a hypersensitivity mechanism.

Acute Disease↗
PubMed1995

[Presentation, diagnosis and treatment of pyogenic liver abscess: analysis of a series of 63 cases].

BACKGROUND: The aim of this study was to know the clinical, etiopathogenic and microbiologic characteristics of pyogenic liver abscesses (PLA). METHODS: A retrospective analysis of the cases of PLA diagnosed from 1978 to 1992 in the Internal Medicine, Infectious Disease, and Gastrointestinal Surgery Departments of the Hospital de Bellvitge in Barcelona, Spain was performed. RESULTS: A total of 63 cases of PLA (43 males and 20 females, mean age 54 +/- 19 years) were analyzed. The most frequent clinical and analytical data included fever (92%), leucocytosis (84%) and abnormal levels of alkaline phosphatase (81%). The PLA were single in 65% and multiple in 35%. Echography was diagnostic in 91% of the cases. A positive culture of the abscess was obtained in 40 cases, being monomicrobial in 27 cases (67.5%). Eleven of the 13 polymicrobial cultures were from single PLA. The most frequent bacteria found were the enterobacteria (44%) followed by the microaerophilic streptococci (28%) and the anaerobes (17%). The PLA was of biliary origin in 31.8%, contiguous in 12.7% and unknown in 38%. Percutaneous drainage was performed in 34 patients (54%). Mortality attributable to the abscess was 3%. CONCLUSIONS: The clinical presentation of pyogenic liver abscess has not varied over time. There has, however, been a change with respect to its epidemiology and therapeutic management. At present, the possibility of rapid diagnosis and image guided percutaneous drainage offers a better prognosis for this disease.

Adolescent↗
PubMed1995

Splenomegaly in sarcoidosis: a report of 16 cases.

The reported frequency of splenomegaly in sarcoidosis has ranged from 1% to 40%. Splenomegaly has been associated with clinical evidence of more extensive extrathoracic sarcoidosis. In a previous study, we reported that splenomegaly was associated with a poor outcome of the disease. The aim of the present study was to describe the characteristics of the sarcoidosis patients with splenomegaly seen at our institution. Of 284 sarcoidosis patients, followed up at our hospital, 16 (5.6%) had splenomegaly on physical examination. These patients showed other extrathoracic manifestations as well, and all but two showed intrathoracic involvement. Eleven patients received corticosteroid therapy. Splenectomy was done in three patients, but the natural history of their sarcoidosis remained unaltered two years after diagnosis. The results of this study disclosed that patients with splenomegaly had evidence of extensive pulmonary and extrathoracic sarcoidosis with a poor prognosis in spite of steroid therapy.

Adolescent↗
PubMed1994

Multiple liver abscesses due to Yersinia enterocolitica discloses primary hemochromatosis: three cases reports and review.

We report three cases of multiple liver abscesses due to Yersinia enterocolitica that led to previously unknown diagnoses of primary hemochromatosis. Y. enterocolitica is an iron-dependent bacterium that relies entirely on exogenous iron for growth. A review of the literature with use of MEDLINE (National Library of Medicine, Bethesda, MD) disclosed 35 cases of Y. enterocolitica liver abscesses; 21 (60%) of these cases were associated with hemochromatosis. In 11 of the remaining 14 cases, two common manifestations of hemochromatosis, diabetes mellitus and cirrhosis of the liver, also were present; these findings were significant. Finally, we emphasize that when iron overload cannot be documented at the time of diagnosis of the liver abscess, long-term follow-up for determination of increasing iron stores is mandatory. With this approach, most manifestations of hemochromatosis in asymptomatic patients can be prevented.

Adult↗
PubMed1994

AIDS presenting as septic shock caused by Mycobacterium tuberculosis.

Concurrent with the AIDS epidemic, an increasing incidence of tuberculosis has been noted. In HIV-infected patients with immunodeficiency, atypical forms of tuberculosis are seen. A case of disseminated tuberculosis with septic shock in an elderly patient with previously unknown HIV infection is reported.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Sarcoid pleural effusion: a report of two cases.

Two patients with pleural effusions have been seen among 270 patients with sarcoidosis in an eighteen-year period. In both patients pleural effusions were present at the onset of sarcoidosis and associated with extensive pulmonary or extrathoracic involvement. Pleural effusions were exudative with a high lymphocyte count. One patient was successfully treated with corticosteroids and the second died from cardiac complications of the disease.

Aged↗
PubMed1994

Chronic ascites in late onset systemic lupus erythematosus with antiphospholipid antibodies.

Because doctors are reluctant to diagnose systemic lupus erythematosus (SLE) in elderly patients, the initial diagnosis in this age group is usually tardy. Furthermore, the presenting manifestations in these patients are commonly atypical. We describe a 72-year-old woman in whom chronic ascites with antiphospholipid antibodies was the initial predominant manifestation of subsequently fatal SLE. Only 13 cases of chronic lupus ascites have been reported in the English and French literature. Our patient represents the first case reported in an elderly person.

Aged↗
PubMed1993

[Thoracic actinomycosis].

BACKGROUND: Thoracic actinomycosis is an rare disease in our medium. This fact, together with the variability of its forms of presentation and the difficulty in isolating its etiologic agent, make its diagnosis, particularly difficult. METHODS: A series of 8 cases diagnosed in the years 1988, 1989 and 1990 in two centers (Hospital de Bellvitge-Prínceps d'Espanya and Hospital de l'Esperança) is described with evaluation of the clinical and analytical data and the therapy applied. RESULTS: Species were only identified in 3 cases with Actinomyces israelii in two and Actinomyces odontolyticus in the third. The proven association with Mycobacterium tuberculosis, the presence of distant septic metastasis and eosinophilic pleuritis as forms of presentation are of note. Medical treatment was penicillin or derivatives in all the cases except one which was treated with diagnostic/therapeutic segmentectomy. CONCLUSIONS: It is concluded that when any subacute involvement of the thoracic and/or pleuropulmonary wall specific cultures should be carried out to discard eventual thoracic actinomycosis.

Actinomyces↗