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Biomedical subjects

E Bouza

Publications and source records attributed to E Bouza.

At least 253 records · Page 14Linked to original sources
PubMed1983

Comparison of ceftazidime concentrations in bile and serum.

Biliary excretion of ceftazidime, a new broad-spectrum cephalosporin, was studied in two groups of patients after administration of a 2-g dose intravenously. Group A included 10 patients in whom ceftazidime levels in bile were measured during cholecystectomy. Group B included 10 patients with indwelling biliary tubes in whom ceftazidime levels in bile and serum were simultaneously measured at 0.5, 1, 2, 4, 6, and 8 h after administration of the drug. Although ceftazidime levels were variable, they exceeded the minimal inhibitory concentrations of most biliary tract pathogens in both groups.

Adult↗
PubMed1983

Evaluation of lamoxactam in the treatment of severe bacterial infections.

We investigated the clinical efficiency and safety of lamoxactam for treatment of 28 episodes of infection in 26 adult patients (15 males and 11 females) whose ages ranged from 17 to 83 years (mean 48.7). 4 patients had 'ultimately fatal diseases' and the remaining 22 had 'nonfatal diseases'. The clinical condition at the beginning of treatment was 'critical' or 'poor' in 15 cases. Episodes of infection treated were: 14 intraabdominal, 9 bacteremia, 5 nephro-urinary, 3 osteomyelitis, and a miscellaneous group including pneumonia, soft tissue, parameningeal focus and infected V-P shunt. A total of 34 microorganisms were responsible for 25 episodes of infection. 15 and 10 episodes were mono- and polymicrobial, respectively. Isolated microorganisms included 13 aerobic facultative gram-negative bacillus, 5 facultative gram-positive cocci, and 16 anaerobes. Total dosage of lamoxactam administered by patient ranged from 24 to 234 g (mean 57.6 g), and mean duration of therapy was 15.2 days (range 8-42 days). The overall rate of clinical response to lamoxactam was excellent, amounting to 84% of episodes and 91% of patients. Local and general tolerance was good, and lamoxactam had to be discontinued only once during therapy due to an episode of neutropenia. Enterococcal colonization (5 of 26 patients, 19%) and superinfections (3 of 26 cases, 11.5%) were undesirably frequent in our patients. Lamoxactam seems to be an effective and safe single-agent therapy for many bacterial infections. The possibility of enterococcal colonization and superinfections should be monitored, specially in patients with urinary or intraabdominal infections.

Abdomen↗
PubMed1982

Comparative effects of moxalactam and gentamicin on human polymorphonuclear leukocyte functions.

The in vitro effects of moxalactam and gentamicin on chemotactic, phagocytic, and microbicidal activities of human polymorphonuclear leukocytes have been studied. Incubation of cells with moxalactam (25 to 400 micrograms/ml) resulted in a 10 to 15% inhibition of leukocyte chemotaxis (P less than or equal to 0.10). Incubation of cells with gentamicin (5 to 40 micrograms/ml) inhibited chemotaxis more than 50% (P less than or equal to 0.50). Neither moxalactam nor gentamicin had any effect on phagocytic or microbicidal capacities of leukocytes.

Cell Migration Inhibition↗
PubMed1981

[Acute Q fever: study of 23 patients (author's transl)].

Twenty-three patients with Q fever who were diagnosed over a 3 year period are described. The majority came from the Madrid urban area and less than half had epidemiological antecedents. Nine patients presented with pulmonary infiltrations, 12 with suppressed fever and in 2 criteria for fever of unknown origin were met. The majority had clinical or analytic data of hepatic disease and liver biopsy practiced in 4 patients showed granulomas. Diagnosis was established through the increment of seric antibodies against antigens of phase II C. burnetii, detected by complement fixation test. Acute Q fever is not a rare disease in our environment and must be taken into account when a differential diagnosis is looked for in processes such as fever of short evolution, fever of unknown origin, pneumoniae and granulomatous hepatitis.

Adolescent↗
PubMed1981

Coccidioidal meningitis. An analysis of thirty-one cases and review of the literature.

Clinical and laboratory features of 31 patients with coccidioidal meningitis seen from January 1964 through December 1976 with follow-up through 1979 are reported and data on 114 patients from the literature reviewed. History of exposure to C. immitis, a wide age range, and, in about one third, underlying conditions are noteworthy. Dissemination to the meninges usually occurs within the first few months although diagnosis is frequently delayed. Presenting symptoms and signs of coccidioidal meningitis are varied but signs of chronic meningitis or suggestion of hydrocephalus are prominent. Evidence of acute infection is unusual even with widespread disease. Diagnosis is usually made by demonstration of coccidioidal CF antibodies in the CSF although they are not found in all patients. Some show other direct evidence of C. immitis. Special diagnostic techniques such as CAT scanning for evidence of basilar meningitis or hydrocephalus are valuable. Amphotericin B remains the drug of choice despite the need for long-term therapy and the problems with intrathecal administration. Reservoirs are only occasionally useful but shunts are frequently lifesaving despite complications. Factors associated with a bad prognosis are hydrocephalus, non-Caucasian race, or presence of an underlying disease.

Adolescent↗
PubMed1981

[Fever of undetermined origin in a case of total correction of persistent truncus arteriosus with agenesis of the left pulmonary artery (author's transl)].

A 19 month-old girl diagnosed of truncus arteriosus with absence of the left pulmonary artery and severe truncal valve insufficiency underwent total correction. A non previously diagnosed severe mitral insufficiency required a new operation to implant a Bjork-Shiley supraanular mitral prosthesis. The postoperative period was hemodynamically normal, except for the presence of persistent fever of unexplained origin. The clinical picture was thought to be an infectious endocarditis due to the late appearance of an aortic prosthetic leak. Because of failure to medical treatment a reoperation was performed to replace aortic prosthesis. Patient died eight hours postoperatively. Autopsy revealed a correct surgical repair, absence of endocarditis and severe miliary disseminated tuberculosis. Authors consider of interest to present this case-report due to the rarity of: a) correction of truncus with a single pulmonary artery under two years of age; b) associated mitral insufficiency; c) the presence of tuberculosis, difficult differential diagnosis with infectious endocarditis in a patient with valvular prosthesis.

Aortic Valve↗
PubMed1980

Yersinia enterocolitica Septicemia.

Human Yersinia enterocolitica septicemia is an uncommon condition. Four new cases are reported here and a review is made of 51 others taken from medical literature. Septicemia caused by this microorganism occurs more frequently in the young and in the elderly, and usually involves patients havig previous liver or blood disorders, diabetes mellitus, and other debilitating diseases. Clinically it is indistinguishable from sepsis caused by other organisms of Enterobacteriaceae, but it is important that the clinician bear its existence in mind, since Yersinia enterocolitica strains are usually resistant to beta-lactam antibiotics, whereas they are susceptible to the aminoglycosides and co-trimoxazole, among others. Susceptibilities in the blood isolates from our patients, and in another ten fecal isolates from eight other patients showed the previously described pattern. Our isolates, however, were all susceptible to the new cephalosporins, cefamandole and cefoxitin, and to the experimental ones, HR-756, T-1551, and Ly-127.935.

Adolescent↗
PubMed1979

Bacillus cereus endogenous panophthalmitis.

A case of severe suppurative endogenous panophthalmitis caused by Bacillus cereus resulted from intravenously administered medications. This is the first, to our knowledge, well-documented case of endogenous endophthalmitis associated with this organism. It is recommended that if on Gram's stain of the anterior chamber fluid, Gram-positive rods are seen, chloramphenicol should be administered in addition to penicillin because of the possibility of B cereus infection.

Adult↗
PubMed1978

Infectious osteitis pubis.

Osteitis pubis is a well-recognized painful inflammation involving the structures of the anterior half of the pelvic girdle, but its cause remains controversial. Biopsy and culture of the pubic bone in 3 patients with osteitis pubis after implantation of a urinary anti-incontinence device were consistent with pubic osteomyelitis which responded to antibiotic therapy. Infection was also found in almost all previously reported cases of osteitis pubis subjected to similar biopsy and culture. Bone biopsy and culture should be strongly considered before initiating frequently unsuccessful empirical therapy in patients with osteitis pubis.

Aged↗
PubMed1978

Group G streptococcal endocarditis.

The group G streptococcus may be a more common human pathogen than previously recognized. A case of group G streptococcal endocarditis is reported and the 11 cases reported previously are reviewed. Group G endocarditis may have significant clinical and prognostic differences from endocarditis caused by the more commonly identified viridans or group D streptococci. Routine serologic grouping of beta-hemolytic streptococcal isolates from serious infections is warranted.

Diagnosis, Differential↗
PubMed1978

Infections in hairy-cell leukemia.

In order to determine the nature of infectious complications in hairy-cell leukemia we studied 20 consecutive patients seen at UCLA and analyzed the available literature. The incidence of serious infection in our series was 40%, and pneumonia and septicemia due to Pseudomonas and E. coli organisms were the leading types of infections. Fungal infections with Cryptococci and Histoplasma organisms were documented, and a single case of Pneumocystis carinii pneumonia was observed. Noninfectious fever occurred in 30% of our patients. There was a clear relationship between fungal disease and corticosteroid therapy, and the overall incidence of infection was correlated with the degree of neutropenia and corticosteroid treatment. No relationship was found between age, duration of disease, or the use of cytotoxic chemotherapy and infectious complications. Of the 13 infectious episodes, 11 occurred in patients prior to splenectomy. Only two episodes were seen in splenectomized patients, both occurring in the immediate postoperative period. We conclude that splenectomy has a beneficial effect in reducing the incidence of infections in hairy-cell leukemia and that corticosteroids should be used cautiously, since they predispose to opportunistic infection in this disease.

Adrenal Cortex Hormones↗
PubMed1977

Immune haemolytic anaemia and renal failure induced by streptomycin.

A case of acute immune haemolytic anaemia and renal failure induced by streptomycin, is reported. The clinical features are similar to those in a case previously reported in which no in vitro proof of antibodies was obtained. In this case, streptomycin-specific IgG antibodies, with both k and lambda light chains, could be demonstrated. The streptomycin bound strongly to the red cell membrane, apparently through chemical groups related to the M antigen and possibly also to the D antigen. Complement-fixation by the drug-specific IgG antibodies, after reaction with the streptomycin-coated red cells, could also be demonstrated. On the basis of these findings, our conclusion is that a complement-fixing hapten-cell mechanism was the main cause of the intravascular haemolytic episode suffered by the patient on exposure to streptomycin. This drug had been prescribed 15 years earlier for pulmonary tuberculosis and he had since injected himself with it whenever he felt "flu" symptoms, without harmful effects, until now.

Acute Kidney Injury↗
PubMed1977

Paracoccidioidomycosis (South American Blastomycosis) in the United States.

The findings in a patient with paracoccidiodomycosis (South American blastomycosis) diagnosed by open-lung biopsy and treated successfully with a combination of trimethoprim and sulfamethoxazole are reported, and the clinical spectrum of the disease is reviewed. Although paracoccidioidomycosis is rarely encountered in the United States and is clinicially similar to other deep mycoses, it should be considered in patients who are suspected of having a fungal infection and have had previous exposure in an area endemic for paracoccidiodomycosis.

Granuloma↗
PubMed1977

Immunological findings in immunoblastic lymphadenopathy. A detailed case study.

Several immunological parameters were investigated in a patient with immunoblastic lymphadenopathy (IBL). An increased concentration of polyclonal immunoglobulins, the presence of autoantibodies in the serum and an increased level of B lymphocytes with an abnormal DNA synthesis response to LPS in peripheral blood were the most salient features. The findings suggest that in IBL there is a numerical as well as a functional alteration of peripheral blood lymphocytes. We propose that the alteration was due to either an escape of lymphocytes from central lymphatic organs or a defect in maturation of peripheral blood lymphocytes.

Autoantibodies↗
PubMedDate not supplied

The CLED agar option in urine culture routine. A prospective and comparative evaluation.

Current recommendations for routine urine culture are still inoculation of specimens in a combination of solid media, usually blood agar (BA) plus MacConkey agar (MK). We have performed a prospective blind study comparing the accuracy of CLED agar (C), as the sole medium, with classic procedure (BA+MK). We included 1157 urine samples plated on the three culture media simultaneously. After incubation for 20-22 hr at 37 degrees C, the cultures were read by two of the authors independently. The cultures were evaluated according to standard criteria (BA+MK) considering a count above 10(4) CFU/ml as significant. The numbers of positive, negative, and contaminated cultures were 233, 764, and 160, respectively. Sensitivity and specificity of CLED were 98% and 99%, respectively. Fastidious microorganisms were accurately detected on C agar as well as on BA+MK. Morphologic differentiation of colonies was easier with C agar, and time required for inoculating and reading the plates was logically less in the C group. As the productivity of C is similar to that of standard procedures, its economy and convenience make it a medium worth using for routine culture of urine samples.

Agar↗