Search PubMedSearch

Biomedical subjects

L Lozano

Publications and source records attributed to L Lozano.

14 recordsLinked to original sources

[An analysis of the interruptions in general medicine consultations].

AIM: To find out the number and nature of the interruptions which occur in general medical consultations. DESIGN: Prospective study lasting two months. SITE. Two representative primary care consulting rooms in an urban health centre (a family and community medicine teaching centre). PATIENTS AND OTHER PARTICIPANTS: All the interruptions which occurred on the days chosen within the period of study were analysed. MEASUREMENTS AND MAIN RESULTS: The two consulting rooms had an average of 10 and 6.8 interruptions a day: which suggests that, in 91% and 54% respectively of the consultations that took place, some type of interruption occurred. The average length of the interruptions was 35 and 16 seconds, which represented 3.2% and 1.1% of the total time of the consultations. The members of staff who caused most interruptions were janitors (30.6% and 37%), followed by clerks (24.1% and 22.5%). However those who took the most time in their interruptions were clerks (25.4% of the total time in one consulting room) and nurses (30.3% of the total time in the other consulting room). The majority of the interruptions (63% and 53%) were considered unjustified. The handling over of analyses and further tests (15.8% and 21.4%); the bringing-in of certificates stating inability to work (16.5% and 18.1%); and the bringing-in or taking-out of clinical notes (15.1% and 11.2%) accounted for the most common causes of interruption. CONCLUSIONS: There is a need to organise the health centre's infrastructure so that as few interruptions as possible take piece actually during a consultation, given the bad effect they have on the doctor-patient relationship.

Age Factors

[Immunologic evaluation of 246 HIV patients].

The authors report the results of the immunological studies carried out on 246 individuals infected with the human immunodeficiency virus (HIV) in order to compare these data with those obtained in a previous study. They demonstrate an appreciable increase in the number of women with HIV infection and the change of the major cause of infection, in men as well as in women, from transfusions to heterosexual relations with promiscuous and/or bisexual men. They emphasize the danger of HIV infection in pregnant women because of the possibility of infection in their children.

Acquired Immunodeficiency Syndrome

Leishmaniasis in Colombia. I. Studies on the phlebotomine fauna associated with endemic foci in the Pacific Coast region.

Studies on the phlebotomine fauna related to the leishmaniasis endemic foci of the Colombian Pacific Coast were carried out in the municipalities of Tumaco and Buenaventura. In Inguapí del Guadual, Tumaco, Lutzomyia trapidoi and Lu. gomezi were the predominant anthropophilic species; Lu. panamensis and Lu. hartmanni were less frequent. In Bajo Calima, Buenaventura, Lu. trapidoi represented over 94% of the anthropophilic sandflies. Continuous sampling from 1800 to 0600 hours in Inguapí del Guadual demonstrated that Lu. trapidoi bites mainly at dusk and dawn whereas Lu. gomezi remains active throughout the night. In Inguapí del Guadual, promastigotes were found in 0.1% (2/2, 305) of Lu. trapidoi, 0.2% (3/140) of Lu. gomezi, and 0.2% (1/424) of Lu. panamensis samples collected. In Bajo Calima, 1.9% (8/429) of Lu. trapidoi were found to be infected. Leishmania braziliensis panamensis, the most common Leishmania subspecies in the human population of this endemic focus, was isolated from 1 Lu. trapidoi from Inguapí del Guadual. Parasitological and entomological findings suggest that Lu. trapidoi could be the main vector of Leishmania in these areas, although Lu. gomezi and Lu. panamensis were also predominant.

Animals

IgA nephropathy: association of a history of macroscopic hematuria episodes with increased production of polymeric IgA.

From the clinical point of view patients with IgA nephropathy present two main symptoms. Some patients have episodes of macroscopic hematuria, either isolated or recurrent, while others present only asymptomatic urinary abnormalities. Although these differences could be due to age-related, geographical or other unknown reasons, in this paper we studied whether patients with these two clinical manifestations differ in some IgA immunological aspects, described occasionally as abnormal in this disease. The following results were obtained: patients having a history of macroscopic hematuria episodes (n = 29) had a significant increase in the percentage of blood polymeric-IgA-producing cells (68 +/- 12%) and in the T cells with IgA Fc-receptors (T alpha cells; 14.5 +/- 3%) in relation to those having only asymptomatic urinary abnormalities (n = 13; 48 +/- 11 and 11.8 +/- 3%, respectively). However, there was no difference in the two groups of patients in relation to the serum IgA levels, percentage of IgA-bearing cells, in vitro synthesis of IgA, T-cell subpopulation and generation of Con A-IgA suppressor cells. Since these patients did not differ in the age of the apparent onset of the disease, in age at the moment of the study or in the activity of the disease determined by hematuria, our results afford an immunological support suggesting the existence of two subgroups of patients with IgA nephropathy.

Adolescent

Perioperative cefamandole prophylaxis against infections.

Seven hundred and seventeen patients were included in a prospective randomized double-blind trial comparing the efficacy of five doses of cefamandole (group I, 335 patients) with that of a single preoperative dose (group II, 382 patients) for prophylaxis against sepsis in patients who had an operation using either a Moore prosthesis, Ender or Küntscher nails, a bone plate, or another internal-fixation device. Patients who had an open fracture or total joint replacement were not included in the study. The two groups were similar in terms of mean age, sex ratio, duration of preoperative hospital stay, underlying risk factors, and type of surgical procedure. A wound infection developed in none of the seventy-four patients in group I and in five (6.6 per cent) of the seventy-six in group II (p = 0.03) who required a Moore prosthesis. A wound infection developed in three patients (1 per cent) in group I and in fifteen (5 per cent) in group II (p = 0.006) who required an internal fixation device other than a Moore prosthesis. Staphylococcus aureus, Staphylococcus epidermidis, and gram-negative bacilli were the most common infecting organisms. The rate of mortality was similar in both groups, while the percentage of postoperative urinary-tract infections was lower in group I (p = 0.04). No adverse side effects of the drug were encountered.

Adult