Search PubMed⌕ Search

Biomedical subjects

J Mensa

Publications and source records attributed to J Mensa.

At least 109 records · Page 6Linked to original sources
PubMed1989

[Acute enteritis caused by Salmonella: effect of mecillinam and cotrimoxazole on the clinical course and fecal carrier state].

In a prospective randomized study we have evaluated the influence of co-trimoxazole and mecillinam on the clinical outcome and the fecal Salmonella sp carrier status in 134 adult patients with acute non-typhi Salmonella sp enteritis. The patients were distributed in three groups on the basis of predefined clinical and biological criteria, depending on their risk of bacteremia or severe complications of it, or on the enteroinvasive character of the causative organism. The inclusion in any group determined the treatment. Seventy-six patients received mecillinam (1.200 mg/day p.o.), 36 co-trimoxazole (1.600 mg/day p.o.), both during five days, and 22 only diet. The patients were investigated after 1, 3 and 6 weeks until stool culture was negative. The isolated Salmonella strains, either in stool or blood culture, had a sensitivity of 98.3% to mecillinam and 96.9% to cotrimoxazole. Resistance did not develop during therapy. All patients had a favorable outcome, including the six with bacteremia. No differences were found regarding clinical features (diarrhea, abdominal pain, fever) or the rate of positive stool cultures in the three therapeutic groups in any of the follow-up controls. It was concluded that the administration of mecillinam or co-trimoxazole to patients with Salmonella sp enteritis is not associated with a prolongation of the state of fecal carrier or with the development of resistant strains.

Adult↗
PubMed1989

[Treatment of atypical pneumonia with josamycin].

In the present study the clinical efficacy and tolerance of josamycin (1 g every 12 hours) was prospectively evaluated for the empirical therapy of patients below 70 years with community acquired pneumonia of atypical presentation (AP), without respiratory failure, radiological cavitation or risk factors of pharyngeal colonization by gram-negative bacilli. During a 28-month period 168 patients adequate for the study were included. The etiological diagnosis was established in 56 cases (33.3%); in 55 by seroconversion (28 Mycoplasma pneumoniae, 22 Legionella pneumophila, 1 Chlamydia psittaci and 4 Coxiella burnetii) and in only one case by positive blood culture (Streptococcus pneumoniae). The mean duration of therapy was 9 days and that of fever 1.4 days. Five patients (3%) had mild transient gastrointestinal complaints. No patient required a change of therapy. Relapses were not observed in the 45 days of follow up. In conclusion, josamycin (1 g/12 h p.o.) is an effective and well tolerated antibiotic for the therapy of pneumonia by M. pneumoniae or L. pneumophila, and it represents a good empirical treatment of AP in patients below 70 years without risk factors of GNB infection, respiratory failure or radiological cavitation.

Adolescent↗
PubMed1988

Necrotizing external otitis treated with ciprofloxacin. A case report.

Necrotizing (malignant) external otitis is a severe infection caused by Pseudomonas aeruginosa which occurs mainly in elderly diabetics or in immuno-depressed patients (Chandler, 1968). The management of this condition requires the association between an aminoglycoside antibiotic and an antipseudomonal beta-lactamic, given parenterally during a 4 to 6 week period. Sometimes it is necessary to continue the therapy for months until there is no evidence of residual disease (Strauss et al., 1982). Ciprofloxacin is a quinolone with antipseudomonal activity which can be taken orally, and it is a useful alternative to the current treatment. The authors report a case of necrotizing external otitis which was successfully treated with ciprofloxacin.

Aged↗
PubMed1988

Characteristics of tuberculosis in HIV-infected patients: a case-control study.

To test the hypothesis that HIV infection can modify the clinical characteristics of tuberculosis, 65 consecutive cases of tuberculosis in HIV-seropositive patients diagnosed in Barcelona (Spain) were compared with 65 HIV-seronegative controls matched for age and sex. Thirty of the 65 cases were accepted as AIDS cases (August 1987 Centers for Disease Control criteria) only because of the tuberculosis. Among the cases 54 (83%) were parenteral drug addicts and 88% were males. The tuberculosis was pulmonary or pleural in 62 controls (96%) but in only 25 cases (39%; P less than 0.0001). Lymph nodes were involved in 25 cases (39%) and in none of the controls (P less than 0.0001). Disseminated forms of tuberculosis were present in seven cases (11%) and in no controls (P less than 0.007). Bone, joints and central nervous system involvement were also significantly (P less than 0.05) more frequent in cases. The treatment (isoniazid and rifampin for 6 months plus ethambutol and pyrazinamide during the first 2 months) was always effective. One relapse was detected after a median follow-up of 55 months in cases and none in controls after a median follow-up of 43 months. Twenty-five cases (39%) and 14 controls (22%) developed mild or severe side effects related to the treatment (P less than 0.004). In conclusion, most of the HIV-infected patients with tuberculosis were drug addicts with extrapulmonary or disseminated forms. A short course of treatment (6 or 9 months) may be enough but side effects were frequent.

Acquired Immunodeficiency Syndrome↗
PubMed1987

Candida albicans endocarditis possibly related to systemic candidiasis in a heroin addict.

A case of Candida albicans endocarditis is described which developed in a heroin addict with aortic valvulopathy after an episode of cutaneous and chondrocostal candidiasis related to the use of "brown" heroin. To our knowledge this is the first case reported in the English literature. This complication should be suspected in all heroin addicts with this new syndrome, especially if valvulopathy is present.

Adult↗
PubMed1987

Henoch-Schönlein purpura complicating staphylococcal endocarditis in a heroin addict.

A 21-year-old heroin addict with right-sided staphylococcal endocarditis developed skin purpura, abdominal pain, bloody diarrhea, proteinuria and microscopic hematuria. Skin biopsy showed leukocytoclastic vasculitis with IgA deposits in dermal vessels and renal biopsy disclosed proliferative glomerulonephritis with granular mesangial IgA and fibrinogen deposition. These features are typical of Henoch-Schönlein purpura. Symptoms abated spontaneously. Since the syndrome appeared during cloxacillin therapy, both this drug or the infectious disease itself could have triggered the immune response. Henoch-Schönlein purpura is a distinct clinical entity that can complicate the course of staphylococcal endocarditis.

Adult↗