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Biomedical subjects

E Maraví

Publications and source records attributed to E Maraví.

9 recordsLinked to original sources
PubMed1996

A predictive model for the treatment approach to community-acquired pneumonia in patients needing ICU admission.

OBJECTIVE: To create a predictive model for the treatment approach to community-acquired pneumonia (CAP) in patients needing Intensive Care Unit (ICU) admission. DESIGN: Multicenter prospective study. SETTING: Twenty-six Spanish ICUs. PATIENTS: One hundred seven patients with CAP, all of them with accurate etiological diagnosis, divided in three groups according to their etiology in typical (bacterial pneumonia), Legionella and other atypical (Mycoplasma, Chlamydia spp. and virus). For the multivariate analysis we grouped Legionella and other atypical etiologies in the same category. METHODS: We recorded 34 variables including clinical characteristics, risk factors and radiographic pattern. We used a multivariate logistic regression analysis to find out a predictive model. RESULTS: We have the complete data in 70 patients. Four variables: APACHE II, (categorized as a dummy variable) serum sodium and phosphorus and "length of symptoms" gave an accurate predictive model (c = 0.856). From the model we created a score that predicts typical pneumonia with a sensitivity of 90.2% and specificity 72.4%. CONCLUSION: Our model is an attempt to help in the treatment approach to CAP in ICU patients based on a predictive model of basic clinical and laboratory information. Further studies, including larger numbers of patients, should validate and investigate the utility of this model in different clinical settings.

APACHE↗
PubMed1996

[Low flow cavernous sinus fistula. Treatment by highly selective embolization].

Carotid-cavernous sinus fistulae are anomalous communications between the carotid artery and the cavernous sinus. They are classified according to whether they are traumatic or spontaneous, but distinction in relation to the anatomical origin of the branches of the carotid artery which supplies them is more important. The anatomy of the regional vasculature is analysed in this article. The vessels most frequently involved in spontaneous dural fistulae are the internal maxillary artery (from the external carotid) and the meningohypophyseal trunk (from the internal carotid) which anastomose respectively with the inferior cavernous sinus artery and with the ascending pharyngeal artery. We present two cases of spontaneous carotid-cavernous fistulae. Both were type D of Barrow's classification, and in view of progressive changes in the visual fields, it was decided to proceed with invasive treatment by highly selective embolization of the branches of the external carotid artery, which is currently the treatment of choice in such cases. Good results were obtained.

Aged↗
PubMed1982

[The Aicardi syndrome].

The authors present a case of a girl who showed flexion spasms, chorio-retinopathy and agenesis of corpus callosum, an association known as the Aicardi syndrome. They have made a wide revision of the literature, examining in detail the clinical aspects and diagnosis with other malformations and infections. Lastly, they comment the aspects of etiology and pathology of the disease which still remain unclear.

Abnormalities, Multiple↗
PubMedDate not supplied

[Tolerance to interferon beta-1b amongst patients with remittent recurrent multiple sclerosis after more than one year of treatment].

INTRODUCTION: Interferon beta-1b modifies the natural history of the remittent recurrent forms of multiple sclerosis. An analysis was made of its efficiency, tolerance and adverse effects on patients with over one year of treatment. MATERIAL AND METHODS: 16 patients were studied (10 women, 6 men) with ages between 19 and 51 years, incapacity scale (EDSS) 2.61 +/- 1.07 and an annual rate of outbreaks before treatment of 1.65 +/- 0.25, who received 4 MUI/48 h/s.c. of interferon beta-1b x 15 days, afterwards continuing with 8 MUI/48 h/s.c. Corticoids were associated in four cases. Biochemical controls and mass neurological evaluations were carried out as well as a watch being kept for clinical and analytical secondary effects. RESULTS: The annual rate for outbreaks was 0.68 +/- 0.29. Amongst the most frequent adverse effects the pseudoflu syndrome was notable (87%), with an average duration of 10.46 +/- 1.4 weeks, well tolerated with paracetamol. The local reactions (87%) were light and not related to the zone of injection. The patients experienced a sensation of fatigue following the injection in 50% of the cases, although in only one case did this reach a moderate intensity. Analytical alterations were found to be 43.7%, always within the margins of grade 1 of the clinical toxicity scale. With one patient developed an acute depressive syndrome, during which treatment was interrupted, later restarted at half the maintenance dosage. CONCLUSIONS: In our series, just as in other studies, pseudoflu syndrome and local reactions were the most frequent secondary effects. Both complications are light, of brief duration and well tolerated by the patients.

English Abstract↗