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Biomedical subjects

M Pujol

Publications and source records attributed to M Pujol.

At least 73 records · Page 4Linked to original sources
PubMed1993

Brucellar sacroiliitis: findings in 63 episodes and current relevance.

Between 1974 and 1989 we prospectively observed 530 patients with brucellosis. The findings for 62 patients (42 males and 20 females; mean age, 34.7 years) with 63 episodes in which the sacroiliac joint was involved (the most frequent osteoarticular location [11.7%]) were analyzed. Ten of the older patients (mean age, 55.3 years) had concomitant spondylitis. Systemic symptoms were usually important, and characteristic pain and findings of sacroiliitis were observed in approximately 75% of cases. Blood cultures were positive for Brucella melitensis for 44 patients. The most frequent radiographic findings were blurring of articular margins (42 cases) and widening of the sacroiliac space (20 cases). No radiographic anomalies were detected in 13 cases. Results of 99mTc and gallium-67 bone scans were abnormal in approximately 90% of cases (abnormalities were often mild). Overall, clinical, radiographic, and isotopic bone scan findings were sensitive and useful, although they were occasionally minimal or difficult to evaluate, making diagnostic findings confusing or misleading. Brucellar sacroiliitis is a mild disease associated with a good outcome similar to that observed for patients with uncomplicated brucellosis.

Adolescent↗
PubMed1993

[Nosocomial bacteremia caused by Enterobacter spp.: epidemiology and prognostic factors].

BACKGROUND: The aim of this study was to establish the clinical and epidemiologic features of nosocomial bacteremia by Enterobacter spp. and to analyse its prognostic factors. METHODS: A prospective study of the episodes of nosocomial bacteremia by Enterobacter spp. with clinical significance, detected in a third level university hospital from January 1984 to December 1990 was performed. RESULTS: During the study period, 226 episodes of bacteremia by Enterobacter spp., of which 184 (81%) were of nosocomial origin (8.1% of all the nosocomial bacteremias), while 14% were polymicrobial. An increasing trend was observed in the number of episodes (1984 vs 1990) from 0.9 vs 1.8 episodes per 1,000 admissions, respectively. The mean age was 57 years and the male/female relation was 2.4/1. The most frequent focus of origin was infection of the vascular catheter (43%), followed by intraabdominal catheter (21%), urinary tract (14%), and other foci (17%). Fifty-four percent of the patients had received antibiotics prior to the episode of bacteremia. Most of the cases were detected in the Intensive Care Units (ICU) (41%) and in the gastrointestinal surgery area (24%). Global mortality was 23%. Logistic regression analysis selected an entry site other than infection of the vascular catheter (odds ratio 6.1; CI [95%)] 2.0-18.4), shock (odds ratio, 6; CI [95%], 1.6-21.9) and immunosuppressive treatment (odds ratio, 5; CI [95%], 1.5-16.2) as independent variables of bad prognosis. CONCLUSIONS: Enterobacter spp. is an important nosocomial pathogen taking fourth place in the ranking of nosocomial bacteremia by gram negative bacilli. It predominantly affects a population of patients admitted in the ICU and surgery. The intravascular catheter is a frequent entry site for nosocomial bacteremia by Enterobacter spp.

Adult↗
PubMed1993

[Psychological aspects of bone marrow donation in donor brothers and sisters in bone marrow transplantation].

It appears to be necessary to consider, during a bone marrow transplantation, brothers and sisters who are donors. These children face psychological difficulties, which are not always understood by medical staff and families who are mainly concerned with the health of the sick children. Systematic meetings with a hundred donors point out the distress experienced in these situations.

Bone Marrow Transplantation↗
PubMed1992

[Primary cerebral lymphoma in 10 patients with AIDS. Comparative clinico-radiologic study with cerebral toxoplasmosis, cerebral tuberculoma and primary cerebral lymphoma in non-immunodepressed patients].

BACKGROUND: Primary central nervous system lymphoma (PCNSL) is the second cause of cerebral masses in patients with the acquired immunodeficiency syndrome (AIDS). The present study evaluated the possible presence of clinical or radiologic signs permitting differentiation of AIDS patients and PCNSL from those with cerebral masses of other etiologies. METHODS: Clinical history and cranial computerized tomography (CT) of patients with PCNSL and AIDS from the Hospital Clinic i Provincial in Barcelona were reviewed. Results were compared with those of patients with PCNSL without evidence of immunosuppression and with those with AIDS and cerebral toxoplasmosis or tuberculoma diagnosed during the same period. RESULTS: Of 685 patients with AIDS, 10 were identified with PCNSL. The clinical picture was not different to that observed in patients with AIDS and cerebral toxoplasmosis or tuberculomas. In contrast to PCNSL in non immunodepressed patients, the cerebral CT in patients with PCNSL and AIDS demonstrated hyperdense lesions in only 44% and contrast enhancement was not homogeneous in any case. These characteristics were similar to those observed in the CT of patients with cerebral toxoplasmosis or tuberculoma with the exception that only 8% of the lesions by toxoplasmosis were spontaneously hyperdense. CONCLUSIONS: The clinical-radiological data of primary central nervous system lymphoma in patients with the acquired immunodeficiency syndrome are similar to those observed in other etiologies. However, the presence of a sole spontaneously hyperdense region in cranial computerized tomography is more suggestive of primary central nervous system lymphoma than cerebral toxoplasmosis.

Acquired Immunodeficiency Syndrome↗
PubMed1992

Myokymic discharges and enhanced facial nerve reflex responses after recovery from idiopathic facial palsy.

A functional disorder of facial muscle activity commonly occurs in patients after recovery from Bell's palsy with axonal degeneration. The postparalytic facial dysfunction is probably related to the aberrant growing of regenerating axons, although other theories such as ephaptic transmission, spontaneous generation of impulses, and enhancement of motoneuron excitability should also be considered. In this work, we have carried out a comparative electrophysiological study of both sides of the face in 23 patients who had recovered from a unilateral Bell's palsy with axonal degeneration. At rest, spontaneous firing of motor units was observed in muscles of the previously paralyzed side. Direct motor responses to facial nerve stimulation were smaller in the muscles of the previously paralyzed side, but reflex responses obtained in the same muscles by stimulation of either the facial or trigeminal nerve were larger when compared with those of the contralateral side. These data indicate that patients with "postparalytic facial dysfunction" may have an increased background muscle activity, as well as an enhanced recruitment of facial motoneurons to reflex activation in the side of the previous paralysis. These findings are compatible with an enhanced level of motoneuron excitability in the facial nucleus.

Action Potentials↗
PubMed1992

[Recall of the importance of serological monitoring of children with suspected congenital toxoplasmosis].

Emphasis is put on the need for repeating serologic tests at regular intervals until one year of age in infants with suspected congenital toxoplasmosis. In 11 of 33 cases, antibody titer changes were the only evidence of toxoplasmosis, a disease which may induce severe ocular lesions if appropriate treatment is not given. Although well-recognized as indispensable, serologic monitoring is not always performed; in one group of 326 infants with suspected congenital toxoplasmosis, 133 (41%) were not followed up for more than six weeks.

Enzyme-Linked Immunosorbent Assay↗
PubMed1991

[Serologic and genomic markers of the hepatitis C virus in transfusion recipients with non-A, non-B hepatitis].

BACKGROUND: The exclusion of donors with antibodies against the c-100 protein of the hepatitis C virus (HCV) has permitted a considerable reduction in post transfusional (PTH) non A non B hepatitis in those receiving transfusions. However, the risk has not been completely eliminated and there is evidence that some HCV carriers do not present detectable antibodies against protein c-100. In these cases a new diagnostic methodology, named polymerase chain reaction (PCR), permits the detection of the viral genome. METHODS: One hundred fifty eight prospective transfusion recipients were studied. Nineteen (12%) developed non A non B PTH criteria. The presence of anti c-100 and the viral genome were investigated by PCR in 17 of the patients. RESULTS: Nine of the 17 receptors (53%) with non A non B PTH presented antibodies against the HCV. In all patients and in two seronegative patients genomic sequences of HCV were detected by PCR. CONCLUSIONS: By a combination of genomic (PCR) and serological technique, 11 of the 17 transfusion recipients (64%) with non A non B PTH demonstrated evidence of HCV infection. In two cases the infection was seronegative. Although the HCV appeared to be the principal agent of the non A non B PTH in this study it could not be recognized in a third of the recipients who developed non A non B PTH.

Adult↗
PubMed1989

[Value of IgA detection in the diagnosis of toxoplasmosis].

The detection of IgA in serum by immunocapture agglutination assay is easy to perform in routine. It represents a valuable element for the diagnosis of toxoplasmosis. The presence of IgA, even more than that of IgM, evokes a recent infection. However, caution must be taken in using the results to date back the infection since kinetics of IgA production, like other immunoglobulins, may depend on individual variations.

Animals↗