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Biomedical subjects

G Piédrola

Publications and source records attributed to G Piédrola.

At least 55 records · Page 3Linked to original sources
PubMed1997

In vitro activity of fosfomycin trometamol against pathogens from urinary tract infections: a Spanish multicenter study.

The in-vitro susceptibilities of a total of 1371 urinary tract pathogens to fosfomycin trometamol were determined. According to the NCCLS breakpoints, Enterobacteriaceae and gram-positive microorganisms were, in general, very sensitive to this antimicrobial. More than 90.0% of the Escherichia coli and Citrobacter spp. and more than 70.0% of the Klebsiella pneumoniae, K. oxytoca, Enterobacter spp., Proteus mirabilis, Staphylococcus aureus, coagulase-negative staphylococci and Enterococcus spp. strains tested were susceptible to fosfomycin trometamol. However, Pseudomonas aeruginosa and Acinetobacter spp. strains were more resistant. In general, recent clinical isolates from urinary tract infections (UTIs) in both community and hospital were also very sensitive (> 80.0%) to fosfomycin, its activity being higher than that of the rest of the antimicrobials commonly used for therapy of uncomplicated UTIs. More than 75.0% of the most frequently isolated pathogens from UTIs, except for P. aeruginosa (31.8%) and Acinetobacter spp. (11.1%), were susceptible to fosfomycin trometamol. The results obtained in this study, together with the infrequency of side effects and its pharmacokinetic properties, indicate that fosfomycin trometamol may be a useful alternative for single-dose therapy of uncomplicated UTIs.

Anti-Bacterial Agents↗
PubMed1997

Reliability of four methods for the diagnosis of acute infection by Epstein-Barr virus.

We studied the reliability of new indirect tests in the diagnosis of acute infection by Epstein-Barr virus (EBV). Studied for all samples were method 1, the heterophil antibodies (Abs) (Monolatex, Biokit, Germany); method 2, the IgM Abs to EBV with ELISA tests (antigen pools, Enzygnost, Behring-werke, Germany); method 3, EA (Biotest Diagnostics, Germany); and method 4, the IgG avidity test. The reliability of the four tests for the detection of primary infection by EBV was: sensitivity (method 1: 89.1%; method 2: 100%; method 3: 79.7%; method 4: 99%); specificity (method 1: 98%; method 2: 100%; method 3: 84%; method 4: 100%); positive predictive value (method 1: 97.6%; method 2: 100%; method 3: 73.6%; method 4: 100%), and negative predictive value (method 1: 90.7%; method 2: 100%; method 3: 84%; method 4: 99%). The IgG avidity test (method 4) is simple and automated in the laboratory and is very useful for ascertaining, from a single sample, the time since infection. It is criteria of recent primoinfection higher levels than 55% of IgG with low avidity for the antigen. The investigation of the Abs to antigen pools (method 2) by ELISA of virus had a high reliability, but the investigation of heterophil Abs by latex (method 1) and the Abs IgM to EA (method 2) were lacking in sensibility regarding their use in the diagnosis of the primoinfection.

Acute Disease↗
PubMed1996

Relationship between viral genotype and viral load in patients with chronic hepatitis C.

To determine the distribution of hepatitis C virus (HCV) genotypes and to related genotype to viral load, genotyping and quantification of viral RNA were carried out in 35 patients with chronic hepatitis C. Subtype 1a was most prevalent (43%), followed by subtypes 1b (23%) and 3a (14%). Mean viral load (log HCV-RNA copies/ml) for subtypes 1b, 1a and 3a was 7.1 +/- 1, 5.6 +/- 1.1 and 4.1 +/- 2.4, respectively. The presence of immunoglobulin M was related to the duration of hepatitis and genotype 1 to a more severe hepatic injury and higher viral load. Differences observed in viral load for a single HCV subtype justify the need to quantify HCV-RNA prior to establishing antiviral therapy.

Analysis of Variance↗
PubMed1996

Effects of L-arginine infusion on renal hemodynamics and sodium excretion during hypo-, normo-, and hyperinsulinemia, as studied in dogs.

The response of renal hemodynamics and sodium excretion (NaU) to an infusion of L-arginine, in the presence (experiment I) or absence (experiment II) of endogenous insulin secretion and during a sustained hyperinsulinemic euglycemic state (experiment III), was studied in 10 age-matched beagle dogs. The experiments were preceded by a standard oral glucose tolerance test (OGTT), performed 1 week before experiment I. One week resting periods were allowed between experiments I, II, and III. No differences in renal hemodynamics and NaU were observed between basal (experiment I) and insulin secretion suppressed states (experiment II). L-Arginine infusion increased renal plasma flow (RPF), glomerular filtration rate (GFR), and NaU to a similar extent in both experiments. The hyperinsulinemic-euglycemic state (experiment III) induced a decrease in renal hemodynamics and NaU. In this situation, the infusion of L-arginine increased NaU, but was unable to increase RPF and GFR. Our data suggest that a sustained hyperinsulinemic state can interact with the physiological vasoactive mechanisms involved in the regulation of renal vasculature. These results may be pertinent to human disease, especially in pathological conditions in which insulin resistance is present.

6-Ketoprostaglandin F1 alpha↗
PubMed1996

Insulin resistance in patients with a recent diagnosis of coronary artery disease.

OBJECTIVE: To elucidate whether insulin resistance is present in coronary artery disease (CAD) at diagnosis and to study its relationship with other known cardiovascular risk factors. METHODS: We evaluated the incidence of insulin resistance in 40 newly diagnosed CAD patients. Fifteen healthy subjects were used as a control group. The patients and controls had no previous history of metabolic disorders, and were not being administered any medication that might have affected their insulin sensitivity. Immediately after diagnosis of CAD, a standard 75 g oral glucose-tolerance test (OGTT) and an insulin suppression test (IST) were performed on separate days. The IST consisted of a constant infusion of glucose, insulin and somatostatin for 150 min; insulin resistance was estimated by determining the steady-state plasma glucose (SSPG) concentrations during the last 60 min of the test. The insulin sensitivity index (ISI) was calculated by the formula ISI = (glucose infusion rate/SSPG]x10(3). RESULTS: Insulin resistance, defined by an ISI below the normal range derived from the control group, was present in 82.5% of the CAD patients. As a group, the patients with CAD displayed lower ISI (means +/- SD:29.23 +/- 11.23 versus 50.33 +/- 9.37 dl/kg per min, P < 0.001) than did controls. Serum triglycerides and uric acid were higher and high-density lipoprotein cholesterol levels were lower in patients than they were in controls. No differences were observed in fasting plasma insulin, glucose, total and low-density lipoprotein cholesterol concentration. An abnormal OGTT result was observed in 27 patients. The ISI was low in 88.8% of the patients with an abnormal OGTT result and in 69% of the 13 patients with a normal OGTT result. CONCLUSIONS: Insulin resistance and even impaired glucose tolerance are common findings in CAD at diagnosis. The changes in the lipid profile and in uric acid levels paralleled the changes in insulin sensitivity. These results suggest that insulin resistance might play a role in the development of coronary atherosclerosis and that its early diagnosis might be important in the prophylaxis of CAD.

Aged↗
PubMed1996

Clinical features of adrenal insufficiency in patients with acquired immunodeficiency syndrome.

OBJECTIVE: Adrenal insufficiency (AI) is a well known complication of AIDS. However, the clinical and biochemical features of AI in HIV infected patients have not been extensively studied. DESIGN: A retrospective clinical study. PATIENTS: We reviewed clinical records of 74 AIDS patients with clinical and/or biochemical indications of AI who underwent Synacthen testing in order to determine adrenocortical function during a 5-year period. MEASUREMENTS: AI was diagnosed when cortisol levels failed to rise above 496 nmol/l at any time during the test. Cortisol was measured by RIA. RESULTS: Sixteen patients (22%) were diagnosed with AI. Most were young males and all of them had a known risk factor, principally i.v. drug users. The main complaint was fatigue. Hyponatraemia or hyperkalaemia were uncommon. All of them were severely immunosuppressed, with AIDS-defining conditions from at least 6 months before the diagnosis of AI, and had been diagnosed with at least one disease that has been reported to produce AI in AIDS patients. Survival was poor. Thirteen of these patients (81%) died within 6 months. Basal cortisol levels were lower than 275 nmol/l in 75% of patients with AI but in only 2% of the group of 58 patients who had normal adrenal responses to Synacthen. CONCLUSIONS: Adrenal insufficiency features in AIDS patients with advanced disease, without specific findings and with a history of previous opportunistic diseases. Basal cortisol values at 0830 h lower than 275 nmol/l are highly suggestive of adrenal insufficiency in patients with AIDS.

Acquired Immunodeficiency Syndrome↗
PubMed1996

Diagnosis of cutaneous tuberculosis in biopsy specimens by PCR and southern blotting.

AIMS: To evaluate the use of a gene amplification and hybridisation method for detecting mycobacterial nucleic acid as a possible diagnostic method for cutaneous tuberculosis infection. METHODS: Biopsy specimens from 20 patients with various skin conditions of possible tuberculous aetiology were studied. Six patients had ulcerative nodules, seven lupiform lesions, two non-necrotic granulomas, one scrofulous lichen, one impetigo, one erythematosus lesions, one warty lesions, and one suspected tuberculous lipoma. Biopsy specimens were stained using Ziehl-Neelsen stain and cultured in Lowenstein-Jensen medium. DNA was extracted and then amplified by PCR using primers specific for the Mycobacterium tuberculosis complex. Specificity was confirmed by Southern blotting. RESULTS: Of the specimens, 30% were positive for mycobacteria on staining with Ziehl-Neelsen stain, 60% were culture positive and 85% PCR positive. Only 35.2% of specimens were positive with all three techniques. A further 32.5% were both culture and PCR positive. All PCR negative samples were also negative when cultured or stained with Ziehl-Neelsen stain. Of the PCR positive specimens, 29.4% were negative when cultured or stained. CONCLUSIONS: PCR, using suitable primers, is an efficient and sensitive method for the diagnosis of cutaneous tuberculosis.

Biopsy↗
PubMed1996

Seroepidemiology of measles, mumps and rubella virus infections in normal children and adults in southern Granada, Spain: response to a vaccination programme.

A seroepidemiological study of measles, mumps and rubella virus infection in normal children and adults in southern Granada, Spain, and the response to a vaccination programme was carried out. Protection from the mumps and rubella virus was reduced in the group of 3 to 7 year-old children vaccinated at age 15 months indicating the need for revaccination against rubella as well as the mumps virus.

Adult↗
PubMed1995

Three-year study of antibody to Borrelia burgdorferi in southern Spain.

The prevalence of anti-Borrelia burgdorferi antibodies was studied in Granada, Spain, between January 1991 and November 1993 in 354 patients with suspected Lyme disease (group 1); in 50 patients either with syphilis (n = 32) or without syphilis but with a positive Rapid Plasma Reagin test (n = 18) (group 2); and in 150 healthy subjects (group 3). In addition, intrathecal antibody production was evaluated by EIA in CSF samples obtained from 117 patients in group 1. Anti-Borrelia burgdorferi antibodies were detected by EIA in 58 patients (16.4%) in group 1, 29 (8.2%) of whom were positive by Western blot. Intrathecal antibody production was detected in one patient. In group 2, 8 (16%) patients had a positive EIA result, but none of these was confirmed by Western blot. western blot was negative for all subjects in group 3. The results of this study indicate that anti-Borrelia burgdorferi antibodies are not uncommon in our area, although Lyme disease is rare.

Antibodies, Bacterial↗
PubMed1995

Automated blood culture systems.

This review compares automated systems of blood culture for the detection of positive bottles, excluding mycobacteria. The performance of different systems is influenced by several key variables, including volume of the blood sample, the use of resins, shaking to increase the recovery of aerobic microorganisms, duration of incubation and final subculture. The Bactec, BacT/Alert, BioArgos and ESP systems require further study and technical improvement. There is no single ideal system of blood culture, and combinations of two or more methods are likely to provide the best results.

Autoanalysis↗
PubMed1995

[Activation of cell death in lymphocytes from individuals infected with HIV].

BACKGROUND: In HIV infection, T cells depletion cannot only be explained by direct viral infection. Programmed cell death (PCD), also know as apoptosis or activation-induced cell death, may be responsible for the deletion of reactive T cells that contributes to HIV induced immunodeficiency. We studied the response of lymphocytes in vitro to different polyclonal and oligoclonal (superantigen) activators, and tested whether the stimulation of T cells from individual with HIV infection lead to cell death. MATERIAL AND METHODS: Peripheral blood mononuclear cells, total T lymphocytes, TCD4+ and TCD8+ cells from 10 positive patients, 2 patients with AIDS and 10 negative individual for the virus were cultured in RPMI medium and subjected to stimulation with PHA, PWM and SEB (staphylococcus B enterotoxin). Trypan blue was used to distinguish viable from dead cells. RESULTS: TCD4+ cells from HIV-infected patients die after SEB or PWM activation (almost 40% from asymptomatic and 80% from AIDS), and do not die TCD8+ from the same individuals (around 10-15%), or T cells from seronegative controls. CONCLUSIONS: Lymphocytes from patients with HIV-infection showed as abnormal proliferative response to self-MHC class II restricted recall antigens and PWM whereas the response to PHA was conserved. Probably, apoptosis is triggered by an aberrant form of T cell activation in the mature TCD4+ cell population in HIV-infected individuals.

Acquired Immunodeficiency Syndrome↗
PubMed1995

[Pattern of antimicrobial susceptibility of enterococci strains].

Enterococci resistance to antimicrobials has increased lately. We studied the susceptibility to 12 antimicrobials of 150 enterococci strains coming from hospitalized and outpatients, using the agar dilution method. Teicoplanin, followed by imipenem and amoxicilin-clavulanic acid had the lower minimal inhibitory concentrations. No strains of E faecalis was resistant to ampicillin, whereas 14% of E faecium had minimal inhibitory concentrations over 8 micrograms/ml. The high minimal inhibitory concentrations of cefpirome (64 micrograms/ml) renders this antimicrobial useless in the treatment of enterococcal infections. Betalactamase production and resistance to glucopeptides were not detected. Antimicrobial susceptibility of strains coming for hospitalized or outpatients were similar.

Aminoglycosides↗
PubMed1994

Evaluation of a new reagent for anti-cytomegalovirus and anti-Epstein-Barr virus immunoglobulin G.

The Enzygnost alpha method was tested against the complement fixation test and anti-VCA immunofluorescence to determine the respective titers of anti-cytomegalovirus and anti-Epstein-Barr virus immunoglobulin G antibodies. For cytomegalovirus, the Enzygnost results showed 97.99% agreement with the readings obtained by the alternative method, with 100% sensitivity and 93.7% specificity. For Epstein-Barr virus, Enzygnost showed 97.71% agreement, 100% sensitivity, and 91.11% specificity.

Adult↗
PubMed1993

[Prevalence of anti-Leishmania antibodies in parenteral drug addicts. Yield value of 2 study techniques].

BACKGROUND: The prevalence of antibodies anti-Leishmania in intravenous drug addict (IVDA) patients suspect of visceral leishmaniasis (VL) and the diagnostic profitability of two tests for detecting anti-Leishmania antibodies were studied. METHODS: Serum samples corresponding to 91 healthy non IVDA individuals (group 1), 143 IVDA individuals attended in consultation for febrile illness and lymph node enlargement (group 2) with only one serum determination, and 42 IVDA individuals in whom sequential serologic study (group 3) was performed were analyzed. IgG and IgM antibodies were studied by indirect immunofluorescence (IIF). The individuals of group 1 and 90 of those of group 2 (45 with anti-Leishmania IgG antibodies and 45 without by IIF) were simultaneously studied by ELISA to analyze IgG antibodies. RESULTS: No antibodies were detected in subjects from group 1 with the two techniques used. In group 2 IgG were detected in 43.3% of the patients (titer distribution: 46.8% at 1/32, 32.3% at 1/64 and > 1/64 in 21%). In group 3 seroconversion of IgG was found in 18 cases. In 6 patients IgM was observed: 3 from group 2 (with low titers of IgG) and the remaining pertained to group 3 being accompanied by seroconversion of specific IgG. In the remaining 15 patients of group 3 seroconversion of IgG did not accompany positive IgM. No association was found in the results obtained by IIF and ELISA (p = 0.3; chi 2). CONCLUSIONS: It was found that indirect immunofluorescence and ELISA techniques are complementary methods in the indirect diagnosis of visceral leishmaniasis overall in the population of intravenous drug addicts. In this population acute disease may be manifested by IgG seroconversion with or without positive IgM although IgG seroconversion seems to be a more useful criteria given the greater number of patients in whom it is presented in this form. The high frequency of antileishmania antibodies in intravenous drug addict patients in Spain is of note.

Adult↗