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Biomedical subjects

J Campos

Publications and source records attributed to J Campos.

At least 91 records · Page 5Linked to original sources

Invasive disease caused by Neisseria meningitidis relatively resistant to penicillin in North Carolina.

A case of sepsis and meningitis caused by Neisseria meningitidis with relative resistance to penicillin occurred in North Carolina in August 1992. This isolate was relatively resistant due to decreased affinity of its penicillin-binding protein 2 for penicillin. Such isolates have been reported in Spain, elsewhere in Europe, in South Africa, and in Canada, but invasive disease caused by meningococcal isolates relatively resistant to penicillin was not recognized in the United States before a preliminary report of this case in October 1992. The Centers for Disease Control and Prevention recently retrospectively identified 3 additional cases from 1991. A fifth case occurred in Kentucky in 1993. Surveillance studies of penicillin susceptibility of N. meningitidis isolates suggest such meningococci have existed sporadically in the past. Increases in prevalence and magnitude of penicillin resistance among strains of N. meningitidis would require reconsideration of current clinical practice with regard to treatment of meningococcal disease.

Amoxicillin↗

Involvement of a nodofascicular connection in supraventricular tachycardia with VA dissociation.

We present the case of a patient with episodes of supraventricular tachycardia and atrial dissociation that were terminated by either adenosine or verapamil. Involvement of an accessory pathway was shown by ventricular extrastimuli, elicited during His-bundle refractoriness, that interrupted the tachycardia or advanced the next His potential. The tachycardia circuit was demonstrated to be confined to the nodofascicular region based on the exclusion of surrounding tissues. Atrial activity, including that in the perinodal region, was totally dissociated during tachycardia. The lowest part of the circuit was determined to be located above the Hisian bifurcation, as multiple episodes with either a right or left bundle branch configuration during tachycardia did not modify the HH cycle. The ventricular septum summit was determined not to be involved, as no preexcitation was present during tachycardia or atrial pacing, and the right bundle branch was not part of the circuit. Radiofrequency current applied beneath the tricuspid valve at the His region successfully eliminated the nodofascicular connection with preservation of 1:1 AV conduction. The anatomical substrate underlying the abnormal connection may be either nodofasciculoventricular Mahaim fibers or a duality or dispersion of the nodo-Hisian conducting system.

Adult↗

[Aneurysmal bone cysts of the spinal canal].

Aneurysmal bone cysts (ABC) are rare bone tumors of controversial pathogenesis. In 15% of cases, they are localized in the vertebrae. Despite the absence of anaplasia, their volume and localization are often responsible for incomplete surgical resection. The authors present 5 cases of primary vertebral ABC, 4 females and one male, localized in cervical (3 cases), dorsal (1 case) and lumbar (1 case) spine. Symptoms included rachialgia and torticollis. Radiological and histopathological examination disclosed the typical features of ABC. Pre-operative embolization (in 3 cases) and surgery (complete exeresis in all cases except one) were the therapeutic procedures. During a 39 month median period of follow-up, there was one local recurrence. The only case of incomplete exeresis show not did any evidence of progression until 36 months after operation.

Adolescent↗

[A superior vena cava syndrome secondary to a pleural fibrous mesothelioma].

Benign fibrous or pleural mesothelioma are rare tumors that seem to originate in the mesenchyma (subpleural fibromas). They are usually discovered by chance and the prognosis for the patient is favorable after surgery. If the tumors are large, extrapulmonary signs may be present (hypertrophic osteoarthropathy, hypoglycemia). We describe a case of unusually large fibrous mesothelioma of the pleura that presented as superior vena cava syndrome, a complication not described in the literature.

Adult↗

How often is a perimesencephalic subarachnoid haemorrhage CT pattern caused by ruptured aneurysms?

BACKGROUND: Angiography is usually recommended in perimesencephalic subarachnoid haemorrhage (PM SAH) to rule out a basilar artery aneurysm. However it is not known how often aneurysms are found among patients with a CT pattern of PM haemorrhage or the frequency of this CT pattern after rupture of posterior circulation aneurysms. METHOD: CTs of all SAH caused by posterior circulation aneurysms admitted from 1/85 to 12/92 where reviewed by two examiners. Late (> 72h) examinations were excluded. The remaining CTs were classified in perimesencephalic (PM) or non PM. RESULTS: 81 posterior circulation aneurysms were collected. Only one PM-like CT pattern was found, due to ruptured posterior communicating artery aneurysm (1.3%; 95% Cl (confidence intervals) = .03-6.7%). During the same period 37 PM SAH with negative angiographic results were admitted. The likelihood of finding an aneurysm in a patient with an early CT showing a PM distribution of haematic densities was 2.7% (95% Cl = .07-.14%). CONCLUSIONS: Although the probability of finding an aneurysm in a SAH patient with a PM CT pattern is low, a complete 4-vessel angiogram must be obtained.

Aneurysm, Ruptured↗

Headaches during intracranial endovascular procedures: a possible model of vascular headache.

We report a series of 11 patients who developed headaches during intracranial endovascular procedures performed for the treatment of arteriovenous malformations (10 cases) or aneurysms (1 case). Headache was precipitated either by balloon inflation (3 cases) or by embolization (8 cases), and had a very constant pattern. In all cases the pain started suddenly, reaching maximum intensity at once. Headache was focal, unilateral, ipsilateral to the occluded artery, nonthrobbing and short-lasting (usually less than 10 minutes). It was not associated with gastrointestinal, autonomic, or aura-like symptoms. Headache localization depended upon the catheterized artery, being constant for each of the major vascular territories. Yet, in all patients pain was felt in the cutaneous territory of the ophthalmic division of the trigeminal nerve. The occurrence of headache was not associated with cortical deficit nor cortical irritation (assessed both clinically and by the EEG) and therefore seems to be directly related to the stimulation of the arterial wall. This type of pain can be used as a model of pure vascular headache. Its study can contribute not only to understand the pattern of intracranial vascular innervation but also to understand or to refute the vascular components of migraine.

Adolescent↗

[Multiple antibiotic resistance in Haemophilus influenzae related to serogroup B].

AIM: To study the association between multiply antibiotic resistance in Haemophilus influenzae and H. influenzae type B, and to describe levels and patterns of antibiotic resistance. METHODS: Statistical analysis and susceptibility of 231 H. influenzae strains (52 type B and 179 non-typable ) isolated consecutively from pediatric patients. RESULTS: Resistance levels for type B and non-typable strains were: Ampicillin, 55.3% vs 28.8%; Chloramphenicol, 44.7% vs 9.2%; Ampicillin plus chloramphenicol, 40.4% vs 7.6%; cotrimoxazole, 89.3% vs 67.4%; resistance to six or more antibiotics, 36.0% vs 3.8%. CONCLUSION: Multiply antibiotic resistance in H. influenzae is strongly associated with type B strains, with age of 4 or younger, and with isolation from CSF or blood. Resistance is sustained over long periods of time.

Child, Preschool↗

[Malignant vasovagal syncope: a case of prolonged asystole induced by the "tilt" test and aggravated by therapy with a beta blocker (a clinical case and diagnostic, physiopathologic and therapeutic review)].

The authors describe a case of a middle-age male with recurrent syncope, in whom the tilt test was useful in the diagnosis and therapeutic evaluation. Malignant criteria of vasovagal syncope were established and the beta blocking worsening effect was documented, in spite of the general agreement of the first choice drug.

Adult↗

Genetic change and continuity from fourteen to twenty months: the MacArthur Longitudinal Twin Study.

Genetic change as well as continuity was investigated within the domains of temperament, emotion, and cognition/language for 200 pairs of twins assessed at 14 and 20 months of age in the laboratory and home. The second year of life is marked by change rather than continuity: correlations from 14 to 20 months averaged about .30 for observational measures of temperament and emotion, about .40 for language measures, and about .50 for mental development. 2 types of genetic change were examined: changes in the magnitude of genetic influence (heritability) and genetic contributions to change from 14 to 20 months. In general, heritability estimates were similar at 14 and 20 months. Evidence for genetic influence on change from 14 to 20 months emerged for several measures, implying that heritability cannot be equated with stability. Analyses of continuity indicated that genetic factors are largely responsible for continuity from 14 to 20 months.

Child Development↗

[Resistance in Haemophilus influenzae in Spain. 2d study (1990)].

AIM: To study the resistance to strains of H. influenzae simultaneously isolated during 1990 in 10 Spanish cities with this being the second multicentric study carried out in Spain. METHODS: Three hundred eight strains of H. influenzae were consecutively isolated with less than 50% being from the respiratory tract. The sensitivity by microdilution in supplement Isosensitest was studied. RESULTS: Thirty-five percent of the strains were producers of beta-lactamase which predominate among those isolated in systemic infections and specially among those from Madrid (58.78%) and Barcelona (61.8%). The strains producing beta-lactamase were more resistant to all the antimicrobials than the non producers. Five point two percent of the strains were resistant to ampicillin by non enzymatic mechanisms. Resistance to chloramphenicol is frequent (28.6%) especially among strains producing beta-lactamase, strains of ocular origin and ORL (46%) and systemic infections (74.3%). The distribution is irregular, being more frequent in Seville (66.7%) and not detectable in Barcelona. Resistance to tetracycline is also usually linked to the production of beta-lactamase and not necessarily to that of chloramphenicol. Resistance to cotrimoxazole is the most frequent (67.5%) specially in Valladolid (87.5%). Resistance to cefaclor is of 60.7% being the most frequent among those isolated from ocular processes and ORL. Only 28 strains (9.1%) were sensitive to all the antimicrobials tested. Thirty-nine percent were multiresistant. CONCLUSIONS: The authors found a slight increase in the high resistance detected in 1986. This increase was not uniform in all of Spain being significant in Madrid with producers of beta-lactamase, in Seville to chloramphenicol, to tetracycline in Bilbao and cotrimoxazole in Valencia.

Bacterial Proteins↗

Epidemiology and molecular basis of penicillin-resistant Neisseria meningitidis in Spain: a 5-year history (1985-1989).

Penicillin-resistant (penr) clinical isolates of Neisseria meningitidis, which do not produce beta-lactamase, were first identified in Spain in 1985; the frequency of their recovery, which has been increasing in the past few years, reached 20% in 1989. Serogrouping, determination of serotypes and subtypes, and multilocus enzyme electrophoresis of the penr strains showed an extensive diversity. Resistance is due, at least in part, to a decreased affinity of penicillin-binding protein (PBP) 2 for penicillin. Similar low-affinity forms of PBP 2 are also found in penr isolates of Neisseria lactamica, Neisseria polysaccharea, and Neisseria gonorrhoeae. Genetic transformation of an N. meningitidis type strain to low-level penicillin resistance with DNA from resistant meningococci and other Neisseria species resulted in transformants that possessed low-affinity forms of PBP 2. These altered forms of PBP 2 have been shown to arise from recombinational events that replace parts of the PBP 2 gene with the corresponding regions from the PBP 2 genes of commensal Neisseria species.

Bacterial Proteins↗

Genetic diversity of penicillin-resistant Neisseria meningitidis.

The genetic relatedness of 42 penicillin-resistant Neisseria meningitidis isolates obtained during a 2-year period from a single hospital was studied by multilocus enzyme electrophoresis and by restriction fragment length polymorphism (RFLP) analysis of penicillin-binding protein (PBP) 2 genes. The PBP 2 genes of 7 susceptible strains gave identical RFLP profiles. Sixteen different PBP 2 RFLP profiles were found among the 42 resistant strains, but 4 were found in greater than 1 resistant isolate. Multilocus enzyme electrophoresis revealed a high level of genetic diversity. Four clusters of resistant strains could be distinguished at a genetic distance of 0.75. Resistant strains with the most common PBP 2 RFLP profile were restricted to one of these clusters and may be derived from a common ancestral strain. However, resistant strains with the 3 other common RFLP profiles were distributed in two or more of the clusters.

Adolescent↗

Discriminative criteria for Neisseria meningitidis isolates that are moderately susceptible to penicillin and ampicillin.

The prevalence of Neisseria meningitidis isolates that are moderately susceptible to penicillin and ampicillin has increased very quickly in Spain; the current prevalences in our hospital are 48.4 and 55.6%, respectively. We studied the reliability of the disk diffusion method for discriminating between fully susceptible (MIC, less than or equal to 0.06 microgram/ml) and moderately susceptible (MICs, 0.12 to 1.0 microgram/ml) isolates. Thirty-eight isolates (12 Pen(s) Amp(s), 18 Penr Ampr, and 8 Pen(s) Ampr) were assayed by the disk diffusion and plate dilution methods by use of disks of 1, 2, 5, and 10 U of penicillin, 2 and 10 micrograms of ampicillin, and 1 microgram of oxacillin on Mueller-Hinton agar with or without 5% sheep blood. Breakpoints were generated, and their discriminative values were determined with a collection of 195 meningococcal strains isolated consecutively from cerebrospinal fluid or blood. None of the strains produced beta-lactamase. Penicillin- and ampicillin-susceptible strains (MIC, less than or equal to 0.06 microgram/ml) had oxacillin inhibition zones of greater than or equal to 11 mm on blood agar. Moderate susceptibility to ampicillin and penicillin was suggested by an inhibition zone of less than or equal to 10 mm around the 1-microgram disk and an inhibition zone of less than or equal to 26 mm around the 2-U penicillin disk. We conclude that discrimination between fully susceptible and moderately susceptible populations of N. meningitidis can be accomplished by the disk diffusion method by use of Mueller-Hinton agar plus 5% sheep blood with the 1-microgram oxacillin disk (which is especially suited for screening methods) and the 2-U penicillin disk. The lack of an oxacillin inhibition zone indicates moderate susceptibility to either penicillin or ampicillin or both.

Ampicillin↗

Temperament, emotion, and cognition at fourteen months: the MacArthur Longitudinal Twin Study.

200 pairs of twins were assessed at 14 months of age in the laboratory and home. Measures were obtained of temperament, emotion, and cognition/language. Comparisons between identical and fraternal twin correlations suggest that individual differences are due in part to heritable influences. For temperament, genetic influence was significant for behavioral observations of inhibition to the unfamiliar, tester ratings of activity, and parental ratings of temperament. For emotion, significant genetic influence was found for empathy and parental ratings of negative emotion. The estimate of heritability for parental report of expression of negative emotions was relatively high, whereas that for expression of positive emotions was low, a finding consistent with previous research. For cognition and language, genetic influence was significant for behavioral indices of spatial memory, categorization, and word comprehension. Shared rearing environment appears influential for parental reports of language and for positive emotions, but not for other measures of emotion or for temperament.

Cognition↗

[Idiopathic sclerosing peritonitis (ISP). A report of a new case and a review of the literature].

Idiopathic sclerosing peritonitis (I.S.P.) is a rare disease, in which the small bowel is encased in a fibrous capsule, with symptoms and signs of intestinal obstruction. A new case of I.S.P. in a 42-year-old man who underwent laparotomy and was reoperated for intestinal obstruction is presented. A jejunal fistula with a favorable outcome occurred in this case. The literature about this entity is reviewed, and 16 cases are collected. This condition is being reported more and more commonly and requires further research to elucidate its unknown mechanism.

Adult↗