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Biomedical subjects

Jaime Merino

Publications and source records attributed to Jaime Merino.

11 recordsLinked to original sources
PubMed2003

Porphyromonas asaccharolytica liver abscess.

The black pigmented Gram-negative anaerobes, Porphyromonas species, have been isolated from clinical specimens in cases of central nervous system, dental-oral, pleuropulmonary and genitourinary infections and bacteremia. Herein, we report an unusual case of liver abscess caused by Porphyromonas asaccharolytica that has not been previously reported.

Journal Article↗
PubMed2003

Interest of home blood pressure measurements (HBPM) to establish degree of hypertensive control.

AIMS: To establish the validity and clinical value of home blood pressure measurements (HBPM) in the treatment follow-up of patients with essential hypertension to rule out or to confirm poor control of blood pressure obtained in the doctor's office with a mercury sphygmomanometer. MATERIAL AND METHODS: Observational, cross-sectional study was carried out to validate HBPM in treated hypertensive patients poorly controlled by office-based casual blood pressure measurements. Measurements were made on 2 consecutive days with six readings taken per day. To do this, 2 x 2 tables were drawn up to validate the HBPM using ABPM as the reference method. Sensitivity (S), specificity (Sp), positive probability quotient (+PQ) and negative probability quotient (-PQ) were calculated. The study population (n = 149) was selected by consecutive sampling of the hypertensive patients seen in the Vallada Health Centre. Only 124 patients could be evaluated. RESULTS: Values obtained with HBPM were: S 97.3% (95% CI 90.4-99.7%), Sp 62.7% (48.1-75.9%), +PQ 2.61 (1.82-3.73) and -PQ 0.04 (0.01-0.71). CONCLUSIONS: Home monitoring of blood pressure is a useful alternative to ABPM to rule out office-based poor control of hypertensive patients, but not to confirm it.

Blood Pressure Determination↗
PubMed2002

Tuberculous empyema necessitatis in a man infected with the human immunodeficiency virus.

Empyema necessitatis is a collection of inflammatory tissue that ruptures spontaneously through a weakness in the chest wail into surrounding soft tissues. Although empyema necessitatis can be caused by a number of infectious agents, mycobacteria are the most frequently implicated. Empyema was a much more common complication of pulmonary tuberculosis in the preantibiotic era than it is today. We describe a 22-year-old man with human immunodeficiency virus (HIV) infection who had tuberculous empyema necessitatis and was successfully treated with surgical debridement and antibiotic therapy.

AIDS-Related Opportunistic Infections↗
PubMed2002

[Idiopathic granulomatous hepatitis with bilateral orchiepididymitis and skin eruption].

We report a 52 years old male admitted for fever lasting one month, dry cough, headache and malaise. Initial laboratory work up showed an AST of 172 U/l, and ALT of 252 U/l, a GGT of 353 U/l and alkaline phosphatases of 952 U/l. An abdominal CAT scan disclosed a mild hepatosplenomegaly. A liver biopsy showed a granulomatous hepatitis. During the evolution, the patient had a left testicle swelling with darkening of the surrounding skin. A testicular ultrasound showed a bilateral orchiepidydimitis. The patient was treated with non steroidal anti-inflammatory drugs and fever subsided. Three months later, these drugs were discontinued and the patient remained asymptomatic and with normal laboratory values until 36 months of follow up.

Dermatitis↗
PubMedDate not supplied

[The hospital faced with a prolonged Legionella outbreak].

OBJECTIVE: To describe the health resources used in patients hospitalized with Legionella pneumonia during an outbreak of Legionnaire's disease in Alcoy (Spain), and to compare them with those used in other forms of pneumonia. METHODS AND RESULTS: Using a clinical protocol, 177 Legionella pneumonia patients were compared with 180 patients hospitalized for other types of pneumonia. Data on therapy and the resources used were collected. The most common antibiotic treatment in both groups was clarithromycin, but intensive care and mechanical ventilation requirements were greater in Legionella pneumonia. Home-based hospital care was successfully used in 15.6% of patients with Legionella pneumonia and in 11.3% of those with other types of pneumonia. Home oxygen therapy after discharge was less frequent in the Legionella pneumonia group (7.8%) than in the group with non-Legionella pneumonia (16.7%). CONCLUSIONS: Notable results were the greater requirement for mechanical ventilation in Legionella pneumonia and the good results obtained by home-based hospital care within current health care management.

Aged↗
PubMedDate not supplied

Reversible coma caused by risperidone-ritonavir interaction.

Medications that act on the central nervous system are frequently used in people infected with human immunodeficiency virus (HIV). Actually, drug interactions are an important factor in the treatment of patients with (HIV) infection and because of the complexity of the current drug regimens, clinicians should be trained in order to recognize and manage drug interactions. Herein, we present an HIV infected male admitted for manic behavior and treated with risperidone who developed a profound coma secondary to increased levels of risperidone because of a possible drug interaction with ritonavir and indinavir. Subsequently, we discuss this interaction, rarely described in the literature. Risperidone is a cytochrome P450 (CYP2D6) enzyme substrate and weak inhibitor and a CYP3A4 substrate. Possible interactions with CYP2D6 inhibitors (amiodarone, fluoxetine or ritonavir) and CYP3A4 inhibitors (indinavir and ritonavir) can increase its serum concentrations and produce significant adverse effects. In conclusion, this drug combination should be administered with caution and routinely examined for signs and symptoms of risperidone toxicity. Dosages should be reduced as needed. Finally, we think that in patients taking multiple medications, plasma levels of risperidone should be monitored especially if drug interactions are possible.

Antipsychotic Agents↗
PubMedDate not supplied

Efavirenz-associated gynecomastia: report of five cases and review of the literature.

The prognosis of HIV infection has improved dramatically since the introduction of highly active antiretroviral therapy (HAART). However, numerous adverse effects and limitations regarding tolerability remain a concern. Lipomastia (pseudogynecomastia), a breast enlargement due to central adiposity, may occur as part of a fat redistribution syndrome which has been associated with HAART regimens and several pathogenic mechanisms have been advocated in its development. Here we report an observational longitudinal study of five patients diagnosed of gynecomastia associated with efavirenz-based HAART regimens. All cases reached successful immunologic and virologic responses to HAART. The delay of appearance of gynecomastia from the beginning of HAART ranged between 4 to 15 months. In all five cases, gynecomastia regressed after efavirenz withdrawal (mean period of 5 months). In summary, we think that HAART induced gynecomastia should be suspected in HIV patients receiving efavirenz-containing regimens. Although pathogenesis is unclear, this study and a review of the English literature implicates two possible mechanisms: (a) immune restoration processes and (b) efavirenz mediated estradiol-like effects.

Adult↗