Biomedical subjects
Publications and source records attributed to M Marín.
A disseminated Scedosporium apiospermum infection was diagnosed in a woman with severe asthma and treated with corticosteroids. This fungi is resistant to fluconazole and amphotericin B. The infection was refractory to itraconazole, but responded successfully to voriconazole. A review of the literature is provided.
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Two hundred fifty isolates of Mycobacterium tuberculosis were evaluated for susceptibility to ciprofloxacin, ofloxacin, levofloxacin, grepafloxacin, trovafloxacin, and gemifloxacin (SB-265805). Levofloxacin, ciprofloxacin, and grepafloxacin showed the greatest activity (MIC for 90% of strains tested [MIC(90)] 1 microg/ml), although ofloxacin also showed good activity, with an MIC(90) of 2 microg/ml. Trovafloxacin and gemifloxacin showed lower in vitro activity, with MIC(90)s of 64 and 8 microg/ml, respectively.
Pseudomonas (formerly Flavimonas) oryzihabitans is an uncommon pathogen that may cause catheter-associated infections. Although it has occasionally been isolated from the environment, the source of human infection has not previously been documented. We describe an AIDS patient who developed Pseudomonas oryzihabitans bacteremia due to colonization of a Hickman catheter. The patient reported having strictly followed the recommendations for catheter hygiene. The only flaw detected was the use of a synthetic bath sponge in the shower. The sponge was cultured and yielded P. oryzihabitans among other nonfermentative, gram-negative bacilli. To determine the prevalence of P. oryzihabitans in sponges, we cultured 15 samples from unrelated households. The microorganism was isolated from 3 of the 15 samples. Molecular typing by arbitrarily primed PCR (AP-PCR) was performed with the environmental and clinical isolates. Three different profiles were obtained for the six isolates analyzed from the patient's sponge. The strain from the AIDS patient was identical to one of those from his sponge and was different from all the remaining strains. The AP-PCR typing results were subsequently confirmed by pulsed-field gel electrophoresis. It can be concluded that sponges are occasionally colonized by P. oryzihabitans. For the first time a probable source of an indwelling catheter contamination with this bacterium has been found. Patients carrying these devices should avoid using sponge-like materials, as these are suitable environments for nonfermentative, gram-negative bacilli.
We report a case of bronchial atresia in the apical segment of right down lobule associated to subcarinal bronchogenic cyst in an eighteen years old patient who consults by long time bronchitis. The thorax X-ray shows an image suggested of mucoid impaction. The respiratory function tests are not essential for the diagnostic. The fiber bronchoscopy is normal and the diagnostic is established by mean image technics (thoracic HR-TC and MR).
Whole cell patch-clamp recordings were used to study the electrical properties of the macrophage-like cell line J774.1, after infection with Leishmania amazonensis. Infection induced a significant increase in cell size and membrane capacitance, suggesting that parasite invasion leads to the addition of plasma membrane to the host cell. By 24 hr after infection, the host cell membrane potential was significantly more hyperpolarized than control cells, and this difference remained for the subsequent 72 hr post-infection. The hyperpolarization was paralleled by an increase in the density of inward rectifying K(+) currents. The shape of the conductance vs. voltage curve, the kinetic properties and the pharmacological profile of these currents were not significantly altered by infection. These results suggest that infection by L. amazonensis causes an increase in the number of functional inward rectifying K(+) channels, leading to hyperpolarization of the host cell membrane.
Clavicle fractures represent 5% of all skeletal injuries, and the distal third of the clavicle is involved in approximately 10%-15% of all these fractures. The incidence of delayed union or non-union in Neer type II fractures of the distal third of the clavicle is high. The ideal treatment for Neer type II fractures of the distal third of the clavicle is still open to controversy. Several treatments have been proposed, but there is no consensus about the treatment of choice. The case reported here presents a unique type of fracture of the lateral end of the clavicle that, since a medial fragment is involved, is a Neer type II fracture, but because of the nature of the fracture line the coracoclavicular ligaments remained intact. Trans-bony suture between the two fracture fragments was performed as the only treatment. This treatment has not been previously described and, although it has just been used in a single case, it appears to be an effective, efficient and simple alternative for the treatment of Neer type II fractures of the distal third of the clavicle.
Peridural fibrosis developing after laminectomy may cause pain that can necessitate reoperation. Many materials have been used as a barrier to invasion of fibrous tissue into the vertebral canal, but the ideal material has not been found. Various studies in animals have achieved favourable results with an expanded polytetrafluoroethylene (ePTFE) membrane. In a prospective, randomized study, we compared postoperative results in 33 patients who had an ePTFE membrane implanted to cover the defect caused by laminectomy during lumbar spine decompression with the results in 33 patients in whom no material was implanted. At operation, an ePTFE membrane was placed after the decompression procedure to cover the laminectomy defect completely. Systematic clinical and MRI follow-up evaluations of patients with and without the membrane were conducted 3, 6, 12, and 24 months postoperatively. The effect of ePTFE membrane implantation over laminectomy sites on postoperative peridural fibrosis, pain and neurological claudication was assessed. The ePTFE-membrane group had a significantly lower rate of epidural fibrosis on MRI (P<0.0001) and of clinical manifestations of radiculalgia (P = 0.002) compared with the no-material group. Epidural fibrosis that occurred in the ePTFE group was generally less extensive than that in the no-material group. There was no significant difference in the rate of postoperative claudication in the two groups. Significantly more seromas occurred in the ePTFE group (P = 0.0002). There were no infections or other complications in either group. The results showed that placement of an ePTFE spinal membrane over the laminectomy defect produced by lumbar spine surgery provided a physical barrier to invasion of fibrous tissue into the vertebral canal, and patients with the membrane had less postoperative radicular pain.
OBJECTIVE: To assess the impact of the setting-up of a computer program designed by the Hospital Pharmacy Department as a tool that provides information for the antimicrobial therapy monitoring. To assess its influence on pharmaceutical costs. MATERIAL AND METHOD: The computer application for the follow-up of antimicrobial treatments integrates information from the Pharmacy Department and the Microbiology Laboratory and selects all patients to whom some controlled antibiotic has been prescribed. The pharmacist reviews all the controlled antibiotic treatments, suggests any change to the physician if needed and quantifies the economic impact of the accepted interventions. RESULTS: On average, 12.5% of controlled antibiotic treatments warranted a pharmaceutical intervention, and 92% of them were accepted. The most frequent interventions related to prescriptions were change of dosage and administration route and related to the disease were in respiratory and urinary tract infections. From the economic point of view, the accepted interventions represented a saving of 12,087,029 pesetas (83,359 $)/year, on average. CONCLUSION: The applied computer program resulted a useful tool for a clinical pharmacist to reach more correct antibiotical therapeutics and better cost-effectiveness relation. It also helped to achieve favorable clinical outcomes.
OBJECTIVE: To characterize the epidemiological relationships among Stenotrophomonas maltophilia isolates in the neonatology unit of our institution over a 4-month period in which an increased number of isolates was observed. SETTING: The neonatology ward in a 2,000-bed university hospital in Madrid, Spain. DESIGN: A retrospective molecular epidemiological analysis using three different typing methods, arbitrarily primed polymerase chain reaction (PCR), pulsed-field gel electrophoresis, and enterobacterial repetitive intergenic consensus-PCR, was performed with 11 isolates obtained from seven neonates over a 4-month period. Presumed unrelated isolates also were included as controls. A similarity dendrogram was obtained, to analyze the genetic relatedness among the isolates. RESULTS: All isolates from the neonates, except one, showed a remarkably high homology among their typing patterns for the three methods assayed and clustered in the relatedness dendrogram at 96% similarity. The unrelated strains selected as controls were unclustered. The index case was considered to be a newborn who had an S. maltophilia isolate from a culture drawn on the day of admission to the neonatology unit and which was included in the clustered similarity group. CONCLUSIONS: Such a high genetic similarity among the isolates, together with the presence of an index case who had been colonized or infected by S. maltophilia before arrival at our institution, constitutes the first evidence of nosocomial cross-transmission of this microorganism.
Previous studies have demonstrated the role of polymorphonuclears in asthma, the importance of increases in intracellular concentrations of ionized calcium in the release of chemical mediators, the role of magnesium as natural calcium channel blocker, and the importance of magnesium deficiency in plasma histamine concentration and in tissue prostanoid concentration. The objective of our study was to measure the polymorphonuclear magnesium content in patients with asthma in the interval between attacks. We measured the polymorphonuclear magnesium content, and serum and erythrocyte sodium, calcium, and magnesium concentrations in 21 healthy volunteers and 50 patients with different types of asthma. In our patients, the polymorphonuclear magnesium content was lower than in the control group (P < 0.001), while magnesium levels in erythrocytes and serum and the levels of other ions in erythrocytes and serum were normal. This is the first report to document low polymorphonuclear magnesium content in patients with bronchial asthma. The reduction of polymorphonuclear magnesium content may have an important role in the pathogenesis of asthma.
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We described two cases of meningococcal infection in a family. Both were detected in a period of seven months. We studied the epidemiological markers of strains isolated from cases and close contacts of the second case. The isolate of first case is identical to the rest of strains studied and we suggest the possibility of persistence and transmission of infection of the index case to the close contacts and the second case. In this paper it is discussed the application of control measures to eradicate the meningococcus from the nasopharynx of patients after the illness, principally in workers with close contacts with populations at risk and in epidemic periods.
Changes in left ventricular mass (LVM) were measured by echocardiography in 104 mild and moderate essential hypertensives treated with only one drug for at least 12 months. They were classified into 4 groups. G1: 40 patients (p) treated with atenolol (73.6 +/- 31.8 mg daily), G2: 32 p treated with enalapril maleate (17.7 +/- 8.7 mg daily), G3: 22 p treated with nifedipine (44.0 +/- 10.8 mg daily), G4: control group, 10 mild hypertensives without medication. At the end of the treatment blood pressure (BP) fell significantly in the first 3 groups (G1: 155 +/- 19/.98 +/- 11 vs. 136 +/- 11/86 +/- 15 mm Hg, G2: 163 +/- 19/104 +/- 10 vs. 139 +/- 12/90 +/- 8 mm Hg, G3: 166 +/- 17/103 +/- 7 vs. 142 +/- 7/85 +/- 7 mm Hg, p less than 0.001), but remained unchanged in G4. Heart rate was reduced significantly only in G1. Body weight did not change (71 +/- 7 vs. 67 +/- 7, p greater than .05). Patients were subclassified according to wether they had normal (N, LVM less than 120 g/m2 in females, LVm less than 135 g/m2 in males) or increased (H) LVM. There was a significant reduction in LVM in all H subgroups (G1 163 +/- 37 vs. 131 +/- 27 g/m2, G2: 155 +/- 19 vs. 126 +/- 21 g/m2, G3: 158 +/- 2 vs. 138 +/- 38 g/m2, p less than .005). The LVM/left ventricular end-diastolic volume ratio (M/V) fell in all H subgroups.(ABSTRACT TRUNCATED AT 250 WORDS)
ELISA test to detect HIV-1 antibodies was performed to 65 homosexuals and homosexual male prostitutes in a Sexually Transmitted Diseases (STD) Clinic in Santiago de Chile together with a survey about risk factors. It was found that 40 of them (62%) practice prostitution with a rate of 1.5% clients per day. All the studied group presented dissemination of HIV risk factors like low frequency usage of condom, patients hide their homosexual condition, they have donated blood, they do not manifest an attitude towards changing their behaviors and have had intercourse with the opposite sex. We found 1 (1.54%) seropositive confirmed by Western blot in a homosexual who does not practice prostitution.
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We report on the results of shock wave extracorporeal lithotripsy in a series of 13 patients with urinary lithiasis and neurologic disease (5 tetraplegics, 6 paraplegics and 2 hemiplegics). Anesthesia, positioning and complementary endourologic procedures in a group of patients in whom many factors contribute to lithogenesis are discussed. Sixteen renal units were treated with good stone fragmentation in all cases. Seventy-five percent of the patients remained stone-free three months later. Complications were few (15%) and minor (mainly post-operative fever) and the hospital stay was short (average 5 days). We advocate this technique as the treatment of choice of urolithiasis in patients with neurologic sequelae because of its safety, relative noninvasiveness and good results, especially in calculi smaller than 2 cm.
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