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Biomedical subjects

E Nieto

Publications and source records attributed to E Nieto.

At least 37 records · Page 2Linked to original sources
PubMed1997

Prevalence and associated factors for gallstone disease: results of a population survey in Spain.

We conducted a cross-sectional survey to determine the prevalence of gallstone disease (gallstone or cholecystectomy) in a random sample of the adult population of Guadalajara, Spain. The sample stratified by age and sex was drawn from the municipal census. Stratum sample sizes were proportional to population sizes and to the expected prevalence rates calculated through a meta-analysis of the European literature. The screening protocol included a gallbladder ultrasonography, a questionnaire on personal and family history, a physical examination, and a blood sample for biochemical determinations. The response rate was 61.2%. The overall prevalence of gallstone disease was 9.7% (95% CI, 7.3-12.0). Prevalence was higher (but not statistically significant) in women (11.5%; 95% CI, 8.2-14.7) than in men (7.8%; 95% CI, 4.6-11.1). After controlling for confounding by multiple logistic regression, increasing age, body mass index, dyspeptic symptoms, smoking habit, and use of hypolipidemic drugs were positively associated with gallstone disease. Total serum cholesterol and alcohol consumption were negatively associated.

Adult↗
PubMed1997

Prediction of depressive relapse in remitted bipolar patients using corticotrophin-releasing hormone challenge test.

Abnormalities in corticotrophin (ACTH) and cortisol levels before and after corticotrophin-releasing hormone (CRH) stimulation have been reported in depressed bipolar patients. The ACTH and free cortisol response to the injection of 100 micrograms of synthetic human CRH and plasma cortisol-binding globulin (CBG) levels were measured in 42 lithium-treated patients suffering from RDC bipolar-I disorder in remission, and in 21 age- and sex-matched control subjects. A 1-year follow-up was conducted in order to assess any possible relationship between outcome and the hormonal response. Bipolar patients showed higher baseline and peak ACTH concentrations than controls. A lower net area under the ACTH concentration curve after CRH stimulation predicted depressive relapse within 6 months by multiple regression analysis. The CRH challenge test could be a potentially good predictor of depressive relapse in remitted bipolar patients.

Adrenocorticotropic Hormone↗
PubMed1996

Correlation of in-vitro activity and pharmacokinetic parameters with in-vivo effect of amoxycillin, co-amoxiclav and cefotaxime in a murine model of pneumococcal pneumonia.

In an attempt to determine the susceptibility breakpoints for amoxycillin, co-amoxiclav and cefotaxime in pneumococcal pneumonia, a neutropenic mouse model was established and tested with two strains having different susceptibility to penicillins and cefotaxime. With a penicillin-sensitive strain (MIC/MBC = 0.01/0.01 mg/L) the minimum dosage tested achieving significant cure was 2 mg/kg for amoxycillin, co-amoxiclav and cefotaxime. For the penicillin-insensitive strain (MIC/MBC = 1/2 mg/L), the minimum dosage tested giving significant cure was 50 mg/kg for amoxycillin and co-amoxiclav but 100 mg/kg for cefotaxime. Our results support the belief that MICs of amoxycillin, co-amoxiclav and cefotaxime for pneumococcal strains of < or = 0.5 or < or = 1 mg/L can be considered as clinically relevant susceptibility breakpoints.

Amoxicillin↗
PubMed1996

Development of experimental pneumonia by infection with penicillin-insensitive Streptococcus pneumoniae in guinea pigs and their treatment with amoxicillin, cefotaxime, and meropenem.

Acute respiratory infection with penicillin-insensitive Streptococcus pneumoniae (MIC and MBC, 1 and 2 micrograms/ml, respectively) was established in guinea pigs. Intratracheal instillation of 0.5 ml of an overnight culture of S. pneumoniae concentrated 25 times (approximately 3 x 10(9) CFU) induced a bacteremic and fatal pneumonia in > 85% of untreated animals within 46 h, with a mean +/- standard deviation bacterial count of 8.83 +/- 1.11 log10 CFU in lung homogenates. This model was used to evaluate the efficacies of two doses each of amoxicillin, cefotaxime, and meropenem given 1 h after bacterial inoculation. The antibiotics were given at 8-h intervals for up to a total of four injections. The dose of 50 mg of any antibiotic per kg of body weight gave 66.6% survival, compared with 5.05% survival for untreated control animals (P < 0.001). A dose of 200 mg/kg gave a survival rate of 77.8% for meropenem and 83.3% for amoxicillin and cefotaxime, while survival for untreated controls was 11.1% (P < 0.001). Although antibiotic treatment decreased mortality compared with that in untreated controls, the antibiotics contributed to a high early (less than 9 h after bacterial inoculation) mortality, being 53.5% compared with only 6.06% for the untreated controls (P < 0.001). Quantitative cultures of the lungs of animals that died during the 46-h observation period or that were killed after this time showed a significant reduction in the numbers of organisms among treated animals compared with numbers among the control animals (P < 0.001). The described model is an appropriate system for evaluating antibiotic efficacy in invasive pulmonary infection caused by penicillin-insensitive S. pneumoniae.

Amoxicillin↗
PubMed1995

Antimicrobial susceptibilities of Corynebacterium species and other non-spore-forming gram-positive bacilli to 18 antimicrobial agents.

The susceptibilities of 265 strains of Corynebacterium species and other non-spore-forming gram-positive bacilli to 18 antimicrobial agents were tested. Most strains were susceptible to vancomycin, doxycycline, and fusidic acid. Corynebacterium jeikeium and Corynebacterium urealyticum were the most resistant organisms tested. Resistance to beta-lactams, clindamycin, erythromycin, azythromycin, ciprofloxacin and gentamicin was common among strains of Corynebacterium xerosis and Corynebacterium minutissimum. Ampicillin resistance among Listeria monocytogenes was more prevalent than previously reported. Optochin, fosfomycin, and nitrofurantoin showed very little activity against most organisms tested, but the use of nitrofurantoin as a selective agent in culture medium may prevent the recovery of some isolates. Except for the unvarying activity of vancomycin against Corynebacterium species, the antimicrobial susceptibilities of the latter to other antibiotics are usually unpredictable, such that susceptibility tests are necessary for selecting the best antimicrobial treatment.

Anti-Bacterial Agents↗
PubMed1994

Problems in minimum inhibitory concentration determinations in coryneform organisms. Comparison of an agar dilution and the Etest.

The antimicrobial susceptibility of 159 coryneform organisms was determined by an agar dilution and Etest methods. Overall, the correlation between minimum inhibitory concentrations obtained by both techniques was good (> or = 0.09) for most antibiotics and organisms although the essential agreement ranged from 59% to 88.3%. Most organisms were equally categorized (sensitive, intermediate, or resistant) by both methods with only 0.2%, 0.4%, and 3.5% of very major, major or minor discrepancies, respectively. Such percentages dropped significantly when discrepant strains were retested. The correlation was specially good for Corynebacterium jeikeium and Corynebacterium urealyticum.

Actinomycetales↗
PubMed1994

Identification of bloodmeal sources of Lutzomyia spp. in Peru.

Bloodmeal sources of Lutzomyia spp. were determined, using the bloodmeal analysis precipitin test, in Chaute, Lima, Peru, an area endemic for cutaneous leishmaniasis (uta). From April 1990 to May 1991, sandflies were sampled in and around the village houses, with CDC light traps and a Shannon trap with protected human bait, respectively. Overall, 1424 sandflies were collected engorged. In indoor collections, human blood (N = 275) was the most frequent bloodmeal found, followed by cow (171) and cat (152). The most frequent bloodmeals of the flies caught in the Shannon trap collections were from cow (31), man (23) and cat (23). Of the two predominant sandfly species in the area, Lutzomyia peruensis was more anthropophilic than Lu. verrucarum (chi 2 = 14.13, P < 0.001). The sandflies from Chaute appear to be opportunistic feeders; 16 different hosts were identified. There was evidence of bloodmeals from more than one host in each of 151 sandflies, including bloodmeals containing blood from an animal only present within the houses mixed with blood from animals only present in the corrals near the house. Some sandflies must therefore have flown from the corrals to the houses (or vice versa) to take the last bloodmeals before their capture.

Animals↗
PubMed1994

[Pneumonia in patients undergoing heart surgery].

OBJECTIVE: We performed a follow-up study of 104 consecutive patients who underwent cardiac surgery to ascertain the following: 1) the incidence of nosocomial pneumonia (NP) in this patient population; 2) the differences in the incidence of NP between patients who underwent coronary artery bypass grafting (CABG) vs. valvular replacement (VR), and 3) the identification of risk factors which predispose patients to the development of NP. RESULTS: The study included 104 patients of which 49 underwent VR, 43 CABG and 12 who had both procedures performed simultaneously. Six of the 104 patients developed NP (5.7%). Five of these patients had undergone VR where as opposed to only one in the CABG group. Pulmonary hypertension preoperatively was a risk factor for the development of NP. Of the 49 patients in the VR group, 46 had pulmonary artery pressures (PAP) recorded, and from their 23 (50%) had pulmonary hypertension. However, 4 of the 5 (80%) patients who developed NP had elevated PAP. The mortality among patients with NP was high. Sixty six percent of patients (4/6) with NP died in comparison to the 10 deaths (10.2%) among 92 patients without NP (p = 0.002). CONCLUSIONS: A trend in the development of NP was observed in patients who underwent valve replacement as opposed to CABG. Because of the small number of patients who developed pneumonia in the study population statistical significance cannot be reached. Pulmonary hypertension in the post operative period is a risk factor for the development of NP. Mortality among patients who develop NP is significantly high (p = 0.002).

Adult↗
PubMed1992

[Suicide attempts in patients with organic disease].

BACKGROUND: The aim of the present was to study the relation between organic disease and suicidal behavior. METHODS: The characteristics of 257 patients hospitalized for medical or surgical causes following attempted suicide were studied between June 1984 and June 1990 with 45 cases previously having had physical disease being compared with 212 that had not. RESULTS: Ninety-seven percent of the attempted suicides with organic disease fulfilled the DSM-III-R criteria for some psychiatric diagnosis with affective disorders predominating (64%). Suicides with organic illness tended to be older (p less than 0.0001), present a larger number of widowed patients (p less than 0.0001), have affective disorders (p less than 0.0001), non violent modes of suicidal behavior (p less than 0.008), and have a preference for non psychotropic drugs and barbiturates (p less than 0.007). CONCLUSIONS: Patients with organic disease who make serious attempts to commit suicide are characterized by high psychiatric morbidity (97%) with a predominance in the diagnosis of severe depression.

Adult↗
PubMed1992

Serious suicide attempts in affective patients.

A retrospective study was carried out including all patients who in the previous 6 years had required admission to our hospital for medical or surgical reasons following attempted suicide (n = 257). Those diagnosed as having affective disorder (n = 96), according to DSM-IIIR criteria, were compared with the other non-affective suicide attempters (n = 161). Affective patients were significantly different in that they were older, more often women, married or widowed, usually used non-violent methods, made more serious attempts and presented a higher incidence of concomitant physical illness. Affective patients with a history of previous attempts were more likely to be recurrent unipolar depressives or first episode unipolars with a concurrent diagnosis of personality disorder. Most of the depressed patients made the attempt within the first 12 months of the episode. Patients who attempted suicide in the first 12 months of the depression were more likely to use non-violent methods and to receive a diagnosis of bipolar or unipolar recurrent disorder.

Adult↗
PubMed1992

Serious suicide attempts in the elderly.

A retrospective study was carried out including all those patients who, over the last 6 years (n = 257), required admission to our hospital for medical or surgical reasons following attempted suicide. The authors examined a series of clinical and demographic variables. Thirty-eight patients over 65 years of age were compared with 120 patients aged between 30 and 64 years and 99 aged under 30 years. When compared with the other two groups, a significantly higher proportion of elderly patients were widowed and showed affective disorders and concurrent physical illness.

Age Factors↗
PubMed1991

[Psychiatric morbidity in elderly patients admitted to a general hospital. A day-prevalence study].

BACKGROUND: The most common psychiatric diseases in the geriatric population are depression, the acute confusional state or delirium and dementia. METHODS: A prevalence-day study of psychopathology was carried out in the elderly population admitted to the hospital for several medical and surgical conditions. The semistructured psychiatric interview (CIS), cognoscitive miniexamination (MEC) and Zung's depression scale (SDS) were administered. When appropriate, a diagnosis was established following the DSM-III-R criteria. 15% of the overall number of elderly patients were excluded because of severe medical disease or surgical operation on the study day. RESULTS: A 43% prevalence of psychiatric disorders was found. 21% of them had depression and 18% a mental organic disorder with cognitive deficit in the form of dementia (6%), delirium (10%), or both (2%). The depression symptoms were more marked with greater cognitive deterioration, and both were greater with increasing age. In only 10% of the patients considered as psychiatric cases the cooperation of the psychiatric interconsultation team had been requested. CONCLUSIONS: The diagnosis of these diseases (depression, delirium and dementia) is very important because in the elderly population with these disorders a higher morbidity and mortality due to medical causes is found.

Aged↗