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A Noguerado Asensio

Publications and source records attributed to A Noguerado Asensio.

At least 19 recordsLinked to original sources

[Use of rifabutin in cases of toxicity to rifampicin].

Rifampicin is an essential drug in the present treatment of tuberculosis. On some occasions, it cannot be used due to severe adverse effects. Rifabutin is a drug of the same family, with a similar activity and difference adverse effects. This study describes the beneficial results of the substitution of rifampicin with rifabutin in patients with severe toxicity.

Adult↗

[Bacteremia].

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Bacteremia↗

[Anaerobic bacteriemias: clinical and epidemiological characteristics of anaerobic bacteremias in ten years].

BACKGROUND: The anaerobic bacteremia incidence is decreasing during the last years, and although it carries a high mortality rate there are studies that ask about the possibility of avoid anaerobic blood cultures thinking about the clinical prediction capacity of them. The objective of this study is the analysis of incidence and clinical characteristics of anaerobic bacteremias in two periods with 10 years of difference and empiric antibiotic treatment received, and if it was changed when microbiological results were received . METHODS: Prospective study of anaerobic bacteremias during 1985-86 and 1996-97, at university hospital analyzing clinical characteristics, incidence, analysis, evolution and empiric antibiotic treatment received. The statistical analysis was performed with the chi square test or exact Fisher test with statistical significance with p<0.05, talking about variables with p<0.10. RESULTS: The incidence of anaerobic bacteremias was higher in 1996-97 with 24 cases (5.08%), that during 1985-86 with 22 cases (4.24%). The variables with statistical significative differences with p<0.10 were: intrahospitalary adquisition (p<0.10); genitourinary and vascular manipulation (p=0.02 and p=0.06), and hypotension (p=0.034) more frequent during the first period than during the second one. There isn t statistical difference in evolution to cure although the percentage was higher during the second period (62.5%), that during the first one (54.6%), being the empiric treatment very high in both periods. Bacteroides fragilis was the most frequent microorganism and abdominal origin the most frequent one in both periods. CONCLUSION: Although there is a low anaerobic bacteremia incidence this one hasn't diminished in ten years. Anaerobic bacteremias have a high mortality index although the most part of empirical antibiotic treatments are correct. It could ask about the possibility of avoid anaerobic blood cultures or ask about them only in clinic suspicion of them.

Adult↗

[Use of acid-suppressive medications in hospitalized patients].

INTRODUCTION: The acid-suppressive medications are used frequently in hospitalized patients, but some studies suggests that their are overused, especially in the treatment of stress ulcer prophylaxis in low-risk patients. This research determine the frequency of use and indications of acid-suppressive medications in hospitalized patients in a internal medical service. MATERIALS AND METHODS: A at random and retrospective revision of 209 medical records of 661 hospitalized patients during the year 2000 in the V Internal Medical Service of the General University Hospital of Gregorio Marañón (Cantoblanco). DEFINITIONS: Use: any prescription of an acid-suppressive medication, regardless of dosage regimen, in which the patient received at least one dose. Appropriated indication: endoscopical criteria: treatment of active ulcer disease, esophagitis or gastritis. Medical criteria: symptomatic gastroesophageal reflux, dyspepsia, prolonging of previous treatment, as a part of a treatment regimen for H. pylori, relief of dyspepsia caused by nonsteroidal anti-inflammatory drugs, stress ulcer prophylaxis in high risk patients. Inappropriate indication: any other uses were considered not indicated. RESULTS: Of the 209 patients, a total of 157 (75.1%) received acid-suppressive therapy, average age 76 years old, 89 women (56.7%) and 68 men (43.3%). The admitting diagnoses for the admission were: CHF 34 (21.7%), Pneumonia (16.6%), UTI (15.3%) y COPD 18 (11.5%). The use in hospital ward was 84.7% (133), with inappropriate use 72.2% (96), the cause of prescription "no reason" 52.1% (50), and received proton pump inhibitors 46.9% (45). CONCLUSIONS: This study show a high frequency of incorrect use of acid-suppressive medications in hospitalized patients.

Adult↗

[Analysis of prognostic factors for mortality in bacteremia and fungemia at a university hospital. Experience of 10 years].

OBJECTIVE: The objective of this study was to determine the prognostic factors in relationship to evolution to death of bacteremia-fungemia (BF) episodes occurred in 1986 and to compare them with the results obtained ten years later in 1996. PATIENTS AND METHODS: Prospective study of all BF episodes observed at Hospital Universitario La Princesa, Madrid, during the 1985-1986 and 1996-1997 periods. The same definitions were used for the two study periods. The univariate analysis of results was performed with the chi square test and variables with statistical significance with p < 0.10 in the multivariate analysis with the logistic regression model. RESULTS: A total of 984 episodes were analyzed. There was an increased incidence per 1,000 admissions from 23.58 to 28.44. A change in the relationship of nosocomial acquisition (55.5%-42.6%) to community-acquired episodes (44.1%-57.4%) and an increase in gram-positive organisms (39%-48.6%) compared with gram-negative organisms (53.4%-41.8%) was observed. The organisms recovered most frequently in both periods were Escherichia coli and coagulase-negative Staphylococcus. An overall decrease of mortality rate from 26.2% down to 15.9% (OR: 4.52) was noted. Independent factors with poor prognosis in the first period included age over 60 years (OR: 4.52), underlying disease (OR: 2.79; more than one OR: 6.53), respiratory source (OR: 3.86), DIC (OR: 4.79), hypotension (OR: 3.19); as for the second period, the corresponding independent factors included age > 60 years (OR: 6.48), nosocomial acquisition (OR: 2.62), DIC (OR: 18.7), hypotension (OR: 3.07), and inadequate surgical treatment (OR: 7.61). CONCLUSIONS: In the last ten years the incidence of BF episodes has increased. In contrast, mortality rate has decreased. Factors with poor prognosis, including age > 60, DIC, and hypotension, still persist.

Adult↗

[Inadequate ADH secretion syndrome associated with acquired immunodeficiency syndrome].

Within the numerous complications of AIDS, we want to point out the appearance of inadequate ADH secretion syndrome (IADHSS) in 9 out of; patients, which constitutes a higher percentage than in the general population. In all cases IADHSS was associated to lung or central nervous system pathology. In one patient, IADHSS preceded the appearance Pneumocystis carinii pneumonitis. Therefore, if hyponatremia is founding AIDS patients, the existence of adrenal pathology or IADHSS should be suspected.

Acquired Immunodeficiency Syndrome↗