Biomedical subjects
I Calicó
Publications and source records attributed to I Calicó.
[Pneumonias associated with cytomegalovirus in immunodepressed patients].
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[Usefulness of cell cultures in the diagnosis of viral infections. Experience in a hospital laboratory in the last 6 years].
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[Diagnosis of viral infections by laboratory methods].
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[Detection of anticytomegalovirus IgM in patients excreting cytomegalovirus].
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[Respiratory infections associated with a cytomegalovirus].
We report 27 children with respiratory tract disease in whom cytomegalovirus was isolated. These group excludes transplant patients and those on hemodialysis and mononucleosis. At the time of virus studies 7 had pneumonia, 3 chronic bronchopneumopathy, 2 bronchopneumonia, 8 pertussoid syndrome, 6 bronchitis or bronchiolitis and 1 laryngitis with glottic oedema. Virus studies consisted in cell cultures of biological products (pharyngeal exudates and urine). They were positive in 18 pharyngeal exudates, 24 urines, 2 bronchial brushings and 1 bronchoaspiration. In only 5 patients a complete serologic study was performed, with 3 seroconversions and one case of persistent high titers. Three patients had severe immune disease (2 hipogammaglobulinemias) and 1 dysgammaglobulinemia. These findings are discussed.
[Etiology of non-hospital pneumonias].
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[Isolation of cytomegalovirus].
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Isolation of Toxoplasma gondii from immunocompromised patients using tissue culture.
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[Strains of ganciclovir-resistant cytomegalovirus].
BACKGROUND: In countries where the resistance of cytomegalovirus to ganciclovir has been studied, strains resistant to therapeutic doses of this drug have been isolated. When a change in treatment has been impossible the patient has shown bad clinical evolution. The aim of this study was to investigate the presence of these strains in our medium, observe whether the resistances appear in patients previously treated with ganciclovir and determine its implication in the evolution of cytomegalovirus infection. PATIENTS AND METHODS: One hundred twenty-three stains of cytomegalovirus, isolated during the period 1990-1998, corresponding to the following 94 patients were studied: 17 breast feeding children of healthy parents who were negative controls (sensitive strains), 43 organ transplant recipients, 29 AIDS patients, 2 with other immunodeficiencies and 3 children with intrauterine infection. Seventeen patients were studied due to the insidious course of the infection despite treatment. The remaining were random. The technique used was that of growth inhibition of the strains seeded on different gradients of ganciclovir: 0, 1, 5, 10 and 20 microM. The inoculate consisted in a cellular suspension evaluated according to the degree of viral growth. The strains presenting an inhibitory doses 50% (ID 50%) greater than 10 microM were considered as resistant. RESULTS: Eighty-two strains presented an ID 50% lower than 5 microM, 24 from 5 to 10 microM and in the 17 remaining strains, corresponding to 12 patients, the ID 50% was greater than 10 microM. The evolution of these latter 12 patients with strains considered to be resistant to ganciclovir was of death in 8. All were immunodepressed and with a history of having previously received ganciclovir. Another currently has a chronic evolution and the three remaining patients, who presented better immunity, became cured. All patients has a chronic evolution and the three remaining patients, who presented better immunity, became cured. All patients had undergone previous treatment with ganciclovir except two: one patient with Wegener disease treated with acyclovir 15 days before, and the other was an infant of an HIV positive mother who had received the drug. CONCLUSIONS: The presence of cytomegalovirus strains resistant to ganciclovir was confirmed in our patients. The previous use of ganciclovir and, in one case of acyclovir, appears to be implicated in the appearance of resistance. The evolution of the immunodepressed patients with infection by resistant strains was mortal except when their immunity was improved.
[Viral infections associated with intestinal invagination].
Intestinal invagination is rather frequently associated with local tumors, adenovirus infections, and occasionally with Yersinia enterocolitica. However, in many cases the etiology is not known. We have studied 88 children with intestinal invagination in whom cellular cultures of Hep 2 and pulmonary fibroblasts of human embryo have been inoculated with a fecal sample. The clinical reports have been reviewed retrospectively. In 19 patients (21.59%) we obtained an adenovirus and in 12 patients (13.63%) we isolated enteroviruses. These results have been compared with a control group of 1,059 children of a comparable age and during the same period of time who were admitted because diagnoses other than intestinal invagination. All controls where subjected to viral investigation in feces following the same procedure. In 71 of controls (6.7%) there were adenovirus in feces and in 74 cases (6.98%) the culture evidenced enteroviruses. Group differences for adenovirus were statistically significant (p = 0.00000172), whereas infections for enteroviruses reached a small significance (p = 0.03892). Among the 18 patients with intestinal invagination in whom the cultures were positive for adenoviruses, 10 presented a recent high airway infection. In contrast, this infection was only observed in 3 out of the 12 patients with culture positive to enteroviruses. The etiology of intestinal invagination in a large number of patients remains to be established. There are many pathogenic intestinal viruses that might cause intestinal invagination but they may be unable to grow into cellular cultures.
[Toxoplasmosis diagnosed using virologic methods].
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[Hyperthermia caused by exertion in cytomegalovirus infection].
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[Digestive cytomegalovirus disease in AIDS patients].
BACKGROUND: In this paper we study the digestive manifestations of cytomegalovirus (CMV) in AIDS patients. Also, we evaluate the antiviral treatment and the necessity of maintenance therapy. METHODS: Retrospective review of medical charts of all patients with AIDS and digestive CMV disease diagnosed and followed-up since 1983 to december 1993. RESULTS: Of 720 AIDS patients, 96 presented a CMV disease. Among them, 30 patients (31%) complained digestive manifestations. These were 26 males and 4 females, mean age: 37.4 y-old. Risk factors for HIV were: 13 homosex and 12 intravenous drug abusers. Average of time between AIDS diagnosis and digestive CMV disease: 13.4 months. Fourteen patients had esophagitis, 9 proctocolitis, 3 hepatitis, 3 pancreatitis, 2 gastric ulcerations, one small bowel disease and other an oral ulceration. Two patients had a concomitant CMV chorioretinitis. CD4 lymphocytes were below 0.05 x 10(9)/l in 29 patients. Twenty-four patients received antiviral treatment during the acute disease period, with a clinical curation rate of 60%. Seven patients received maintenance therapy and remained free of CMV disease until death. Eleven patients didn't received maintenance treatment. Of them, one patient presented a digestive relapse and two developed a CMV chorioretinitis. Mortality in the first month from diagnosis was 23% and the median of survival time for patients who cured and initial episode of digestive CMV disease was 208 days, wether or not the patient received maintenance therapy or not. CONCLUSIONS: One third of ours patients with AIDS and CMV infection have a digestive disease. This CMV digestive disease appears in patients with a severe immunosuppression. Acute phase mortality was 23%. The median survival was 7 months, independently or receiving maintenance treatment or not.