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Biomedical subjects

E Simarro

Publications and source records attributed to E Simarro.

At least 37 records · Page 2Linked to original sources
PubMed1998

Description of two new isolates of Streptococcus pneumoniae in spain that are highly resistant to cefotaxime.

Two strains of Streptococcus pneumoniae isolated from sputum and bronchoalveolar samples with high-level resistance to cefotaxime (MIC = 8 to 16 microg/ml) are described. One of them, belonging to serogroup 19, was also highly resistant to penicillin (MIC = 16 microg/ml), while the other, of serogroup 14, was intermediate in its resistance to penicillin (MIC = 0.25 microg/ml). To our knowledge, these are the first two strains to be isolated in Spain with such high levels of resistance to cefotaxime.

Adult↗
PubMed1998

[Prospective and comparative study between cefuroxime, ceftriaxone and amoxicillin-clavulanic acid in the treatment of community-acquired pneumonia].

Among community-acquired infections, pneumonia is still a large health problem which is of great interest mainly due its high mortality and morbidity. From 1991 to 1997, 409 patients who had been diagnosed with community-acquired pneumonia and had been admitted to the internal medicine service of a university hospital were prospectively studied. The patients were classified into three groups according to the random antibiotic treatment they had received (ceftriaxone, cefuroxime or amoxicillin-clavulanic acid). The initial characteristics of the patients with regard to epidemiology, clinical description and critical situation were similar in all the groups studied. A total of 36.9% of the cases were documented microbiologically, with the most frequently isolated pathogens being Streptococcus pneumoniae and Haemophilus influenzae. The recovery rate was 92.2% and three patients had a recurrence of pneumonia. Global mortality was 5.8%. No statistically significant differences were found in the evolution of patients treated with cefuroxime, ceftriaxone or amoxicillin-clavulanic acid, with the latter representing an empirical treatment of choice for community-acquired pneumonia.

Adolescent↗
PubMed1998

Plasma lipids, HDL and apolipoproteins, and coronary heart disease in men less than 50 years old. A case-control study.

OBJECTIVE: To determine the predictive value of lipoproteins for early coronary heart disease in men less than 50 years old from southern Europe. METHODS AND RESULTS: One hundred and fifty-seven men less than 50 years old were consecutively evaluated for symptoms of coronary heart disease in a tertiary referral hospital. A group of 415 male miners with mean age of 41 +/- 8 years without clinical or electrocardiographic evidence of coronary disease served as controls. Blood samples were taken by venipuncture as soon as possible after admission to the hospital from cases and after 12 hours of fasting in controls. Plasma concentrations of total cholesterol (TChol), HDL-cholesterol (HDLChol), triglycerides (TG), apoproteins A1 and B and Lp(a) were determined. The odds ratios, as estimators of relative risk, were computed using the Mantel-Haenszel procedure. The odds ratios from highest to lowest were a TChol/HDLChol ratio equal to or greater than 5: 10.7 (95% confidence interval (CI) 6.1 to 18.8), TG > 2.25 mmol.l-1 and HDLChol < 0.9 mmol.l-1: 7.4 (95% CI 3.9 to 14.1), HDLChol < 0.9 mmol.l-1: 6.9 (95% CI 4.5 to 10.6), TG > 2.25 mmol.l-1: 3.3 (95% CI 2.0 to 5.3), Lp(a) > 30 mg.dl-1: 2.7 (95% CI 1.8 to 4.1), Apo B > 120 mg.dl-1: 2.4 (95% CI 1.3 to 4.2), non-HDLChol > 5.2 mmol.l-1: 2.2 (CI 1.4 to 3.3), TChol > 6.5 mmol.l-1: 1 (95% CI 0.6 to 1.6), TChol > 5.2 mmol.l-1: 0.9 (95% CI 0.6 to 1.3). CONCLUSIONS: This study indicates that in males less than 50 years a ratio TChol/HDLChol > or = 5 presents the greatest risk power for early coronary heart disease. Plasma concentrations of TChol alone did not demonstrate to have value as risk factor for cardiovascular disease.

Adult↗
PubMed1998

[The effect of a rational and consensual protocol for the use of ceftriaxone in a general hospital].

In hospitals in Spain there has been a large increase in the use of wide spectrum antibiotics. The objective of this study was to evaluate the influence of a rational, consensual protocol on the use of ceftriaxone. An observational and prospective study was carried out using information provided by the Servicio de Farmacia on the in-hospital prescriptions for ceftriaxone. The study included two groups as follows: a control group (October-December 1995) not taking into account the protocols for antibiotic treatment; and a study group in the same months in 1996 with the consensual protocols taken into account. The criteria for the type of patient, infection, evolution and antibiotic treatment were evaluated according to the criteria in the international literature on this type of study. The initial characteristics of both groups of patients were similar. Following the use of the protocol there was a significantly associated reduction in use (48 cases in the study group vs. 57 cases in the control group), an increase in the appropriate use (31. 57% in the control group vs. 75% in the study group), an increase in the cure rate (70.17% in the control group vs. 91.7% in the study group) and a decrease in hospital stay of 7.53 days (22.59 days in the control group vs. 15.06 in the study group), producing a savings per cured patient of 617.142 pesetas. It was concluded that the consensual protocol and its proper application make for a highly interesting approach given that it allowed for better quality use of ceftriaxone with greater cost-effectiveness.

Bacterial Infections↗
PubMed1997

Diagnosis of brucellosis by using blood cultures.

The performances of three blood culture systems, Hemoline performance diphasic medium (bioMérieux, Marcy l'Etoile, France), Bactec Plus Aerobic/F* (Becton Dickinson, Paramus, N.J.), and Vital Aer (bioMérieux), were compared for the diagnosis of 17 cases of brucellosis. By using a 5-day incubation protocol, positive results were 52.9, 82.4, and 11.8%, respectively. When the protocol was extended to 7 days, the results were 76.5, 94.1, and 47.1%, respectively. Bactec was the fastest system (P < 0.05).

Bacteriological Techniques↗
PubMed1996

Performance of six culture media for isolation of Salmonella species from stool samples.

The relative performance of five plating media [Rambach agar; salmonella-shigella (SS) agar, novobiocin-brilliant green-glycerol-lactose (NBGL), modified semisolid Rappaport-Vassiliadis medium (MSRV), and Salmonella Detection and Identification-2 (SM2)] and selenite broth (SB) subcultured in SS agar in the recovery of Salmonella spp. from 500 human stool specimens was evaluated. On Rambach agar and SS agar, the C8-esterase test was also used for selection of suspicious colonies. Eighty-one samples were positive for salmonellae on at least one of the six media. Sensitivities and specificities of MSRV, SB, NBGL, SS, Rambach agar, and SM2 were 95.1 and 98.1%, 87.6 and 99.8%, 79 and 91.9%, 69.1 and 99.3%, 56.8 and 96.9%, and 54.3 and 92.4%, respectively. There were statistically significant differences between MSRV and NBGL, Rambach agar, SS agar, and SM2 (p < 0.005), between SB and SS agar, Rambach agar, and SM2 (p < 0.05), and between NBGL and SM2 and Rambach agar (p < 0.005). The greatest number of isolates was recovered with MSRV, whose performance surpassed that of enrichment in selenite broth, probably because the subcultures were not repeated on MSRV. This hypothesis is now under investigation. The specificity of each of the five solid media was greater than 90%.

Bacteriological Techniques↗
PubMed1995

[The effect of gallopamil and propranolol in patients with ischemic cardiopathy and moderate depression of ventricular function].

BACKGROUND: Calcium channel blockers have been wide and successfully used in the treatment of coronary heart disease. Gallopamil, a metoxylic derivative of verapamil, has many of its properties and so, caution is recommended when given to patients with depressed left ventricular function. Clinical studies about this effect are scarce, and we have assessed it in patients with coronary heart disease and diminished left ventricular function. METHODS: We studied 20 patients in a cross-over, randomized, double-blind study during three weeks active periods with two intercalating washout placebo periods of one week. Patients had history of previous myocardial infarction, positive exercise stress test and ejection fraction ranging from 30% to 50% by echocardiography. RESULTS: There were no significant differences between each drug and corresponding placebo on either systolic or diastolic function. When we compared both drugs, patients showed a milder increase in area under E after propranolol than after gallopamil (p < 0.008). Clinical episodes of cardiac failure were not reported, and ejection fraction did not change. CONCLUSIONS: Both gallopamil and propranolol can be used in patients with coronary heart disease and moderately depressed left ventricular ejection fraction.

Adrenergic beta-Antagonists↗
PubMed1994

Atrial rupture and sudden death following atrial infarction.

We present a sudden-death case secondary to a right atrial rupture, occurring as a result of a myocardial infarction with very subtle clinical and electrocardiographical signs. This atrial infarction case illustrates the difficulty of diagnosis and also the serious consequences that can result from this medical condition. We review other potential complications which, in clinical practise, are not always attributed to their true origin.

Aged↗
PubMed1994

[A change in the prescription of thrombolytic treatment in elderly patients. The experience of the Hospital de León].

INTRODUCTION AND OBJECTIVES: Most deaths caused from AMI occur in elderly patients, and it is know that these patients way also benefit from the type treatment normally offered to younger patients. We proposed to analyse how our therapeutic strategy has evolved for patients of advanced age related to the admission in the CCU and the prescription of thrombolytic treatment. METHODS: In order to carry our investigation, we compared the clinical profile, the treatment and the results of patients over the age of 70 who were hospitalized in our Service with suspected AMI during last 3 years. A total number of 366 which were divided into two consecutive periods of 18 months; 176 patients from January'91 to June'92 (Period I--former--) and 190 patients from July'92 to December'93 (Period II--latter--). RESULTS: In both periods, nearly all patients with suspected AMI and < 48 hours of since symptoms began were hospitalized in the CCU irrespective of their age. In both periods, over 40% of the total number of patients admitted to CCU were > 70 years (I: 45.2% vs II: 42.6%). We observed that in the latter group a major part of patients had complicated AMI at the moment of admittance (I: 15.3% vs II: 24.2%; p < 0.05). This is probably related to a less favorable clinical profile. Despite this, a parallel increase in hospital death rate was not observed (I: 21% vs II: 17%; p: NS). Over time, the ratio of patients prescribed with thrombolysis > 70 was nearly doubled (I: 13.7% vs II: 24.7%; p < 0.01), without a detected increase in complications of hemorrhages. CONCLUSIONS: For a variety of factors, the number of elderly patients admitted with complicated AMI has increased. In our experience the simple modification in the way thrombolysis is prescribed is capable of restraining the hospital death rate ratio.

Aged↗
PubMed1994

[Aortic valvular endocarditis caused by Brucella melitensis with initial acute myocardial infarction manifestation].

This is the case of a 31 year old man with Brucella aortic valvular endocarditis which first manifested itself clinically as an acute myocardial infarction (AMI). He subsequently developed an acute aortic regurgitation, which together with the ventricular disfunction secondary to the myocardial necrosis caused severe heart failure requiring aortic valve replacement and aortic coronary graft in a first operation. The patient's subsequent evolution was negative with congestive heart failure refractory to medical treatment. For this reason he was submitted to a second operation in which an orthotopic cardiac transplant was carried out with good results. The patient remains symptom-free and has returned to his work.

Adult↗
PubMed1985

Left ventricular function after myocardial infarction: clinical and angiographic correlations.

There is a paucity of information correlating the angiographic findings immediately after myocardial infarction with the clinical status before infarction. Therefore, the coronary anatomy, collateral circulation and quantitative left ventricular function were studied in 39 patients who underwent angiography within 3 weeks of a first transmural myocardial infarction. In all patients, the vessel supplying the infarct was totally occluded at the time of angiography. Patients without angina before infarction (Group I) had fewer coronary obstructions than did patients with a long history of angina before infarction (Group II) (1.5 +/- 0.5 versus 2.5 +/- 0.5, respectively, p less than 0.001) but worse overall and regional left ventricular function. These paradoxical differences between Groups I and II were evident in patients with anterior as well as inferior infarction. Patients in Group I had significantly lower collateral scores than did patients in Group II (0.6 +/- 0.8 versus 1.9 +/- 0.9, respectively, p less than 0.0001) and 13 of 22 patients in Group I had no collateral vessels compared with only 1 of 17 in Group II (p less than 0.001). Partial preservation of anterior wall function in Group II patients with anterior infarction was related both to the presence of collateral vessels and to the more distal obstruction of the left anterior descending coronary artery in these patients as compared with patients with anterior infarction in Group I. In contrast, in patients with inferior wall infarction, no relation could be found between the presence of collateral vessels and regional left ventricular function, although only two patients in this series with inferior infarction did not have collateral vessels.(ABSTRACT TRUNCATED AT 250 WORDS)

Angina Pectoris↗