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Biomedical subjects

A Gardella

Publications and source records attributed to A Gardella.

11 recordsLinked to original sources

[Human immunodeficiency virus infection at a primary care center].

We report a descriptive study of 56 cases of HIV infection in a primary care center to evaluate its impact on the population on care, the practices at risk, the associated infections and the difficulties for control. The distribution by age, sex and practices at risk is in agreement with most series from our area. Remarkably, there is a greater rate of drug abusers and sexual promiscuity, related with the marginal type of population on care. We found a high prevalence of the most commonly associated infections, tuberculosis, syphilis and hepatitis B. This association justifies screening for these diseases and the use of the adequate prophylactic and therapeutic measures. We found important difficulties for the follow up of these patients. All these facts emphasize the need to approach this increasing health problem from the primary care setting, basically from the health education of the person with practices at risk and the overall follow-up of the involved patients.

Acquired Immunodeficiency Syndrome↗

[The reasons for medical and nursing appointments in a primary health care center (Barcelona)].

The programmed visit, which is basically generated by the health care team, permits a rationalization of the demand and the introduction of health promoting activities. We have evaluated our motives (medical and nurse practices) for the appointment of patients during 1987. We have also recorded the age, sex, compliance and source of the appointment in a sample of 198 medical and 223 nurse appointments. 62.5% of the appointed visits corresponded to females and more than 50% to patients over 59 years. The most common type of appointment was to control chronic disease, owing to its high prevalence and the protocolization of its care. In individuals under 45 years appointments were mostly for diagnostic approach and to record the clinical history. The implementation of preventive measures appeared as one of the least common causes. Failure to comply was seen in 25%, being higher in patients under age 45 and in the appointments to record the clinical history. These results point to the need of restructuring the concertation priorities. The health problems of the population and its vulnerability are the factors that should guide health planning.

Age Factors↗

[Tuberculosis in a primary care center in a socioeconomically depressed area: variables associated with giving up treatment].

We report the features of 72 patients with tuberculosis of a low socioeconomical level, seen at the primary care center of Perecamps (Barcelona). We identify the factors associated with giving up therapy. We found a predominance of males and of the 40-59 years age group. In 1988 we found an increased rate of young patients (20-39 years) and PDA/HIV+. Twenty-five patients (35%) had had previous episodes of tuberculosis. 19 had had inadequate chemotherapy because of abandonment. The rate of follow-up losses was high (36%). A history of previous PDA/HIV+ were associated with giving up therapy. We indicate the several measures to be applied in our area to improve compliance with chemotherapy in patients with tuberculosis.

Adult↗

In vitro activity of ciprofloxacin, a new carboxyquinoline antimicrobial agent.

The in vitro activity of ciprofloxacin (Bay o 9867), a new carboxyquinoline antimicrobial agent, was compared with those of norfloxacin, nalidixic acid, and several other oral and parenteral antimicrobial agents. Ciprofloxacin was substantially more active than nalidixic acid or cinoxacin against all gram-negative bacteria tested. Virtually all strains of Enterobacteriaceae were inhibited by the new drug at concentrations of less than or equal to 0.125 micrograms/ml. Ciprofloxacin was more active than norfloxacin against Klebsiella sp., Enterobacter sp., and Serratia marcescens, and it was the most active agent against Pseudomonas aeruginosa (MIC90, 0.5 micrograms/ml). The new drug also demonstrated significant activity against gram-positive cocci, inhibiting all strains of staphylococci at concentrations of less than or equal to 1.0 microgram/ml. Ciprofloxacin was bactericidal at concentrations near the MIC against most isolates tested. Although stepwise increases in resistance were seen with Escherichia coli and P. aeruginosa during serial passage on plates containing incremental concentrations of the drug, significant resistance did not emerge during incubation of strains in broth containing concentrations of ciprofloxacin above the MBC.

Anti-Bacterial Agents↗

In vitro activity of U-63196E, a new cephalosporin, against clinical bacterial isolates.

The in vitro activity of U-63196E, a new cephalosporin, was compared with those of other extended-spectrum cephalosporins and penicillins against clinical bacterial isolates. Against Pseudomonas aeruginosa, the activity of U-63196E was comparable to those of cefoperazone and piperacillin, each of which inhibited 90% of strains at concentrations of less than or equal to 16 micrograms/ml. The new drug also demonstrated activity against a variety of other bacterial species, but it was generally less active than cefotaxime, moxalactam, and cefoperazone against members of the family Enterobacteriaceae and staphylococci. The presence of any 1 of 10 plasmid-mediated beta-lactamases in a series of otherwise isogenic laboratory strains of P. aeruginosa resulted in a significant reduction in the activity of U-63196E in comparison with its activity against the parent strain, which lacks these enzymes. Combinations of U-63196E with tobramycin demonstrated bacteriostatic synergism against 11 of 20 clinical isolates of P. aeruginosa.

Anti-Bacterial Agents↗

Effects of azlocillin in combination with clavulanic acid, sulbactam, and N-formimidoyl thienamycin against beta-lactamase-producing, carbenicillin-resistant Pseudomonas aeruginosa.

We investigated the effects of the combination of azlocillin with the beta-lactamase inhibitors clavulanic acid and sulbactam and with N-formimidoyl thienamycin against strains of Pseudomonas aeruginosa with R-factor-mediated carbenicillin resistance. The 10 strains tested (1 R-, 9 R+) were isogenic, except for the presence of individual plasmids determining each of nine plasmid-mediated beta-lactamases found in P. aeruginosa. We utilized a checkerboard technique for testing antibiotic combinations. Low concentrations of clavulanic acid produced synergy with azlocillin against the strains producing the TEM-1, TEM-2, PSE-1, PSE-3, and PSE-4 beta-lactamases; for the strains producing the OXA-1, OXA-2, OXA-3, and PSE-2 beta-lactamases, such synergy was not found. With sulbactam, synergy was demonstrated in all strains except that producing PSE-2 beta-lactamase; for several strains, however, the concentration of sulbactam required to produce synergy was substantially higher than that for clavulanic acid. N-Formimidoyl thienamycin was highly active as a single agent against all of the strains, regardless of beta-lactamase production. The combination of N-formimidoyl thienamycin and azlocillin produced synergy against only two of the strains tested.

Azlocillin↗