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Castellano J, Sanz V, Cañas E, Sánchez E. Effect of firing temperature on humidity self-regulation functionality in a ceramic tile composition. Ann Ital Chir 2022. [DOI: 10.1016/j.jeurceramsoc.2022.05.058] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Vanegas-Cardona DM, Saldarriaga-Giraldo CI, Gallego C, Fajardo L, Agudelo A, Lema C, Hurtado-Martínez L, Cañas E. A propósito de la cardiopatía periparto: una etiología olvidada. RCCAR 2022. [DOI: 10.24875/rccar.m21000020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Ramirez-Ramos CF, Saldarriaga-Giraldo C, Yepes-Calderon M, Castilla-Agudelo G, Aranzazu-Uribe M, Saldarriaga-Betancur S, Castro P, Londoño A, Ortega H, Zapata-Sanchez J, Cañas E, Rendon-Isaza JC. Clinical and hemodynamic outcomes and mortality risk factors in patients undergoing pulmonary thromboendarterectomy. Arch Cardiol Mex 2021; 92:312-319. [PMID: 34619746 PMCID: PMC9262292 DOI: 10.24875/acm.21000108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Pulmonary thromboendarterectomy is the current treatment of choice in patients with chronic thromboembolic pulmonary hypertension. The objective of the present study was to analyze the clinical and hemodynamic outcomes and the risk factors for mortality in a cardiovascular center in Colombia. METHODS Cohort study, conducted between 2001 and 2019. All operated patients were included in the study. Risk factors associated with mortality were established by means of a multivariate regression using the COX method and survival was established using the Kaplan-Meier method. p < 0.05 was considered statistically significant. RESULTS Seventy-three patients were operated. Median age was 51 years, 55% of females, 79% had functional Class III and IV. The mean pulmonary arterial pressure was 50 mmHg and 640 dyn.s.cm-5 for pulmonary vascular resistance (PVR). After the intervention, there was a decrease in mean pulmonary artery pressure (p ≤ 0.001) and in PVR (p = 0.357); 21% had evidence of residual pulmonary hypertension. Only 8% and 6% continued with functional Class III and IV at 6 and 12 months, respectively. There were 15 deaths (19.1%; 12% at 30 days). The factors associated with mortality were the diastolic diameter of the right ventricle measured postoperatively (hazard ratio [HR] 10.88 95% confidence interval [CI] 1.97-62, p = 0.007), time of invasive mechanical ventilation (HR 1.06 95% CI 1.02-1.09 p = 0.004), and the presence of complications during the surgical procedure (HR 5.62 95% CI 1.94-16.22 p = 0.001). CONCLUSIONS Pulmonary thromboendarterectomy is associated with excellent clinical and hemodynamic outcomes. The mortality risk factors found are not those usually described in the literature.
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Affiliation(s)
- Cristhian F Ramirez-Ramos
- Department of Interventional Cardiology and Hemodynamics and Department of Cardiology and Heart Failure, Universidad Pontificia Bolivariana, Clínica cardioVID; Medellín, Colombia
| | - Clara Saldarriaga-Giraldo
- Department of Cardiology and Heart Failure, Universidad Pontificia Bolivariana, Clínica cardioVID; Universidad de Antioquia, Medellín; Medellín, Colombia
| | | | - Gustavo Castilla-Agudelo
- Department of Cardiology and Heart Failure, Universidad Pontificia Bolivariana, Clínica cardioVID; Medellín, Colombia
| | - Mateo Aranzazu-Uribe
- Department of Internal Medicine, Universidad Pontificia Bolivariana; Medellín, Colombia
| | | | - Paulina Castro
- Department of Anesthesiology, Universidad Pontificia Bolivariana; Medellín, Colombia
| | - Alejandro Londoño
- Department of Pulmonology and Pulmonary Hypertension Clinic, Clínica cardioVID; Medellín, Colombia
| | - Hector Ortega
- Department of Pulmonology and Pulmonary Hypertension Clinic, Clínica cardioVID; Medellín, Colombia
| | - Jorge Zapata-Sanchez
- Cardiovascular Surgery Department, Universidad Pontificia Bolivariana, Clínica cardioVID; Medellín, Colombia
| | - Eliana Cañas
- Epidemiology Department, Universidad Pontificia Bolivariana, Clínica cardioVID. Medellín, Colombia
| | - Juan C Rendon-Isaza
- Cardiovascular Surgery Department, Universidad Pontificia Bolivariana, Clínica cardioVID, Medellín, Colombia
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Ramírez-Ramos CF, Saldarriaga-Giraldo CI, Yepes-Calderón M, Castilla-Agudelo GA, Aránzazu Uribe M, Saldarriaga Betancur S, Casto P, Gallego C, Londoño A, Rendon-Isaza JC, Cañas E, Porras Á, Uribe-Molano JD. Arterial lactate levels and their prognostic value in patients undergoing pulmonary thromboendarterectomy. Arch Peru Cardiol Cir Cardiovasc 2021; 2:96-102. [PMID: 38274565 PMCID: PMC10809776 DOI: 10.47487/apcyccv.v2i2.131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 05/24/2021] [Indexed: 01/27/2024]
Abstract
Objective Evaluate the change of lactate levels and its prognostic role in the postoperative period of patients undergoing pulmonary thromboendarterectomy. Methods Retrospective study between 2001 and 2019. Patients older than 18 years and who underwent pulmonary thromboendarterectomy were included. The U Mann Whitney test was performed to evaluate the change between lactate levels, and Cox regression analysis to evaluate the relationship with mortality. Areas under the curve were constructed for lactate levels. Results Seventy-three patients were operated on during the study period. Median age was 51 years, 55% female. The median lactate on days 1 was 4.65 mml/L and on day 2 it was 1.62 mml/L with a change of 2.87 mml/L. No differences were found between the levels measured on day 1 and 2 between the people who died and those who did not on day 30. In the multivariate regression of COX, no relationship with mortality was found. The area under the curve shows regular performance on both day 1 and day 2 in predicting mortality outcomes. Conclusions The behavior of the lactate in patients undergoing pulmonary thromboendarterectomy shows a rapid change during the first hours after the procedure. No role was found as a predictor of mortality neither in-hospital nor in follow-up.
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Affiliation(s)
- Cristhian Felipe Ramírez-Ramos
- Department of Cardiology, Universidad Pontificia Bolivariana, Clínica CardioVID. Medellin, Colombia. Universidad Pontificia BolivarianaDepartment of CardiologyUniversidad Pontificia BolivarianaClínica CardioVIDMedellinColombia
| | - Clara Inés Saldarriaga-Giraldo
- Department of Cardiology and Heart Failure, Universidad Pontificia Bolivariana, Clínica CardioVID. Universidad de Antioquia. Medellin, Colombia. Universidad Pontificia BolivarianaDepartment of Cardiology and Heart FailureUniversidad Pontificia BolivarianaClínica CardioVIDMedellinColombia
| | - Manuela Yepes-Calderón
- Universidad de Antioquia. Medellin, Colombia. Universidad de AntioquiaUniversidad de AntioquiaMedellinColombia
| | - Gustavo Adolfo Castilla-Agudelo
- Department of Cardiology, Universidad Pontificia Bolivariana, Clínica CardioVID. Medellin, Colombia. Universidad Pontificia BolivarianaDepartment of CardiologyUniversidad Pontificia BolivarianaClínica CardioVIDMedellinColombia
| | - Mateo Aránzazu Uribe
- Department of Internal Medicine, Universidad Pontificia Bolivariana, Clínica CardioVID. Medellin, Colombia. Universidad Pontificia BolivarianaDepartment of Internal MedicineUniversidad Pontificia BolivarianaClínica CardioVIDMedellinColombia
| | - Santiago Saldarriaga Betancur
- Department of Internal Medicine, Universidad Pontificia Bolivariana, Clínica CardioVID. Medellin, Colombia. Universidad Pontificia BolivarianaDepartment of Internal MedicineUniversidad Pontificia BolivarianaClínica CardioVIDMedellinColombia
| | - Paulina Casto
- Department of Anesthesiology Universidad Pontificia Bolivariana, Clínica CardioVID. Medellin, Colombia. Universidad Pontificia BolivarianaDepartment of AnesthesiologyUniversidad Pontificia BolivarianaClínica CardioVIDMedellinColombia
| | - Catalina Gallego
- Department of Cardiology and Heart Failure, Universidad Pontificia Bolivariana, Clínica CardioVID. Universidad de Antioquia. Medellin, Colombia. Universidad Pontificia BolivarianaDepartment of Cardiology and Heart FailureUniversidad Pontificia BolivarianaClínica CardioVIDMedellinColombia
| | - Alejandro Londoño
- Department of Pulmonology and Pulmonary Hypertension Clinic, Clínica CardioVID. Medellin, Colombia. Department of Pulmonology and Pulmonary Hypertension ClinicClínica CardioVIDMedellinColombia
| | - Juan Camilo Rendon-Isaza
- Cardiovascular Surgery Department, Universidad Pontificia Bolivariana Clínica CardioVID. Medellin, Colombia. Pontificia Universidad BolivarianaCardiovascular Surgery DepartmentUniversidad Pontificia BolivarianaClínica CardioVIDMedellinColombia
| | - Eliana Cañas
- Department of Epidemiology, Universidad Pontificia Bolivariana, Clínica CardioVID. Medellin, Colombia. Universidad Pontificia BolivarianaDepartment of EpidemiologyUniversidad Pontificia BolivarianaClínica CardioVIDMedellinColombia
| | - Álvaro Porras
- Department of Intensive Care Medicine and Cardiovascular Intensive Care, Clínica CardioVID. Medellin, Colombia. Department of Intensive Care Medicine and Cardiovascular Intensive CareClínica CardioVIDMedellinColombia
| | - Juan David Uribe-Molano
- Department of Intensive Care Medicine and Cardiovascular Intensive Care, Clínica CardioVID. Medellin, Colombia. Department of Intensive Care Medicine and Cardiovascular Intensive CareClínica CardioVIDMedellinColombia
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Sánchez E, Sanz V, Cañas E, Sales J, Kayacı K, Taşkıran M, Anıl Ü, Türk Ş. Revisiting pyroplastic deformation. Application for porcelain stoneware tile bodies. Ann Ital Chir 2019. [DOI: 10.1016/j.jeurceramsoc.2018.09.032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Niebles R, Saldarriaga C, Oliveros MI, Jiménez LM, Suárez P, Sepúlveda A, Cañas E. Predictores preoperatorios de evento cerebrovascular postoperatorio en cirugía de revascularización miocárdica. Revista Colombiana de Cardiología 2015. [DOI: 10.1016/j.rccar.2015.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Rodriguez-Hernandez MJ, Ruiz-Perez-Pipaon M, Cañas E, Bernal C, Gavilan F. Strongyloides stercoralis hyperinfection transmitted by liver allograft in a transplant recipient. Am J Transplant 2009; 9:2637-40. [PMID: 19843038 DOI: 10.1111/j.1600-6143.2009.02828.x] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
We describe a case of Strongyloides stercoralis hyperinfection in a liver allograft recipient 2.5 months after transplantation. The patient lives in Spain, which is not considered an endemic country for strongyloidiasis, and denied prior residence or travel to any known endemic area. The initial symptoms were fever and vomiting, and he subsequently developed a severe respiratory disease. An endoscopic biopsy of ulcerative lesions of the duodenum revealed massive mucosa infiltration by larvae and adult worms, which were also found in respiratory samples. The patient was successfully treated with combined therapy with albendazole and ivermectin. The strongyloides infection was transmitted by the liver allograft. The donor was from Ecuador and, retrospectively, his serum tested positive for S. stercoralis IgG antibodies. Additionally, the pancreas-left kidney allograft recipient from the same donor later developed an intestinal strongyloidiasis without hyperinfection syndrome. To our knowledge, this is the first confirmed case of S. stercoralis infection transmission from the same donor to two solid allograft recipients.
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Bernabeu-Wittel M, Pachón-Ibáñez J, Cisneros JM, Cañas E, Sánchez M, Gómez MA, Gentil MA, Pachón J. Quantitative pp65 antigenemia in the diagnosis of cytomegalovirus disease: prospective assessment in a cohort of solid organ transplant recipients. J Infect 2004; 51:188-94. [PMID: 16230214 DOI: 10.1016/j.jinf.2004.10.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2004] [Accepted: 10/25/2004] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To assess the accuracy of quantitative pp65 antigenemia (pp65Ag) in the diagnosis of CMV disease, in a cohort of solid-organ transplant recipients. METHODS Prospective observational study during the first 6 months following transplantation, with determination of pp65Ag at weeks 2, 4, 6, 8, 10, 11, 12, 14 and 16. Sensitivity (S), specificity (E), positive and negative predictive values (PPV, NPV), and the optimal cut-off point for diagnosing CMV disease, were determined. RESULTS The cohort consisted of 35 liver, 26 renal and 12 heart graft recipients. Thirteen (17.2%) were seronegative and received a seropositive graft. Of 583 blood samples, pp65Ag was positive in 109 (18.7%) from 37 patients (51%). Twenty-two patients developed CMV disease (0.3 episodes/patient); gastrointestinal disease was the most frequent (15 episodes), followed by viral syndrome (3 episodes). Patients with positive pp65Ag had a relative risk for CMV disease of 6.19 [IC95%=1.99-19.04], (P=.0001). Diagnostic values of pp65Ag were: S=86%, E=65%, PPV=51%, NPV=92%. The cut-off of > or =10 infected cells/10(5), at weeks 2, 4, 6 and 8 obtained the best PPV (0, 67, 91 and 54%), and NPV (47, 52, 67 and 50%). CONCLUSIONS In the studied population, the presence of positive pp65Ag was associated with a high risk of developing CMV disease, and the most useful cut-off point for the diagnosis was > or =10 infected cells/10(5).
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Affiliation(s)
- M Bernabeu-Wittel
- Service of Infectious Diseases, Hospitales Universitarios Virgen del Rocío, Avenida Manuel Siurot s/n, 41013 Seville, Spain.
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Sousa JM, Pareja F, Serrano J, Gómez MA, García I, Tamayo MJ, Díaz C, Martín C, Pascasio JM, Hinojosa R, Pérez-Bernal JB, Cañas E, Sayago M, Bernardos A. Comparison between levels of anti-HBS with a fixed administration dose of HBIG and a combination of HBIG and lamivudine for the prophylaxis of hepatitis B after liver transplantation. Transplant Proc 2003; 35:723-4. [PMID: 12644112 DOI: 10.1016/s0041-1345(03)00065-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- J M Sousa
- Hepatic Transplantation Unit, Virgen del Rocío University Hospital, Seville, Spain.
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Villa M, Lage E, Ballesteros S, Cañas E, Sánchez M, Ordóñez A, Borrego JM, Hinojosa R, Cisneros JM. Preemptive therapy for the prevention of cytomegalovirus disease following heart transplantation directed by PP65 antigenemia. Transplant Proc 2003; 35:732-4. [PMID: 12644115 DOI: 10.1016/s0041-1345(03)00068-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Affiliation(s)
- M Villa
- Cardiology, Cardiac Surgery, Intensive Care, Microbiology Department, Hospital Universitario Virgen del Rocio, Sevilla, Spain
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12
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Pereda T, Gavilán F, Giráldez A, Sayago M, Serrano J, Gómez MA, Garcia I, Tamayo MJ, Martin C, Reig M, Hinojosa R, Pérez-Bernal J, Sousa JM, Cañas E, Bernardos A. Hereditary nonsyndromic paucity of intrahepatic bile ducts as an indication for liver transplantation. Transplant Proc 2003; 35:719-20. [PMID: 12644110 DOI: 10.1016/s0041-1345(03)00063-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- T Pereda
- Department of Pathology, Virgen del Rocío, Seville, Spain.
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Gavilán F, Pereda T, Sousa JM, Serrano J, Gómez MA, García I, Tamayo MJ, Martin C, Reig M, Hinojosa R, Pérez-Bernal J, Cañas E, Bernardos A. Hepatic cirrhosis with sarcoid granulomas. Differential diagnosis and liver transplantation: a case report. Transplant Proc 2003; 35:713-4. [PMID: 12644107 DOI: 10.1016/s0041-1345(03)00060-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- F Gavilán
- Departemento Anatomia Patológica y Unidad de Trasplante Hepático, Hospital Universitario Virgen del Rocío, Sevilla, Spain
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Torre-Cisneros J, Herrero C, Cañas E, Reguera JM, De La Mata M, Gómez-Bravo MA. High mortality related with Staphylococcus aureus bacteremia after liver transplantation. Eur J Clin Microbiol Infect Dis 2002; 21:385-8. [PMID: 12072924 DOI: 10.1007/s10096-002-0725-1] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
The aim of the present study was to analyze the characteristics of bacteremia occurring in liver-transplant patients in Andalusia, Spain, during the 1990s. At the three participating hospitals, 405 liver transplantations were performed during the study period, and 119 bacteremic episodes were observed following 91 of them (22.4%, 29.4 episodes/100 liver transplants). Gram-positive organisms were the predominant bacteria isolated in cases of early-onset bacteremia (70.7%, P=0.04). The most common sources of bacteremia were the abdomen (33.6%) and intravascular catheters (22.7%), but frequently the source of bacteremia was unknown (31.9%). Mortality at 30 days was 21%. Isolation of Staphylococcus aureus was the only independent risk factor for mortality (relative risk, 3.13; 95% confidence interval, 1.3-7.5; P=0.01). These results indicate that control measures are required in order to reduce the incidence of gram-positive bacteremia and catheter-related infection in this patient population. The observed etiology must be considered when empirical antimicrobial therapy is indicated while awaiting blood-culture results.
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Affiliation(s)
- J Torre-Cisneros
- Sección de Enfermedades Infecciosas, HRU Reina Sofía, Avenida Menéndez Pidal sn, 14004 Córdoba, Spain.
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Bernabeu-Wittel M, Naranjo M, Cisneros JM, Cañas E, Gentil MA, Algarra G, Pereira P, González-Roncero FJ, de Alarcón A, Pachón J. Infections in renal transplant recipients receiving mycophenolate versus azathioprine-based immunosuppression. Eur J Clin Microbiol Infect Dis 2002; 21:173-80. [PMID: 11957018 DOI: 10.1007/s10096-001-0684-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Differences in the incidence, etiology, type, and outcome of infections occurring during the first 6 months after transplantation were evaluated in two consecutive cohorts of kidney recipients who received immunosuppressive regimens based on either azathioprine (plus antilymphocyte globulin, cyclosporine A, and prednisone) (ATG-AZA cohort) or mycophenolate-mofetil (plus cyclosporine A and prednisone) (MMF cohort). The overall incidence of infections in the two cohorts was similar (0.99+/-1.06 infections/patient in the MMF cohort and 1.04+/-0.99 in the ATG-AZA cohort, P=0.3), as was the incidence of bacterial and fungal infections. In patients who received mycophenolate, cytomegalovirus disease occurred at a higher incidence (0.3+/-0.54 vs. 0.1+/-0.34 episodes/patient, P=0.005) and affected the upper gastrointestinal tract more frequently (0.21+/-0.48 vs. 0.025+/-0.16 episodes of cytomegalovirus ulcerative esophagitis, gastritis, or duodenitis per patient; P=0.001). A nonsignificant trend toward a higher recipient survival for patients receiving mycophenolate was noted (100% vs. 95%, P=0.07). In multivariate analysis, the following factors were independently associated with a higher risk of cytomegalovirus disease: the serostatus R-/D+ (seronegative recipients who received a kidney from a seropositive donor) (RR=35.7 [95%CI, 7.4-166.7]), treatment with mycophenolate (RR=10.4 [95%CI, 2.7-38.4]), and the development of any episodes of acute rejection (RR=10.1 [95%CI, 2.5-41.6]). These data show that kidney recipients receiving mycophenolate have a higher incidence of cytomegalovirus disease, mainly affecting the upper gastrointestinal tract, compared to those receiving azathioprine-based immunosuppression.
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Affiliation(s)
- M Bernabeu-Wittel
- Service of Infectious Diseases, Virgen del Rocío University Hospital, Avenida Manuel Siurot s/n, 41013 Seville, Spain.
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Cisneros JM, Cañas E, Pachón J. [Pre-transplant evaluation of the donor and recipient. Recommendations for surveillance and control of infection after transplantation]. Enferm Infecc Microbiol Clin 1997; 15 Suppl 2:98-103. [PMID: 9312304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Affiliation(s)
- J M Cisneros
- Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen del Rocío, Sevilla
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Martínez-Marcos FJ, Viciana P, Cañas E, Martín-Juan J, Moreno I, Pachón J. Etiology of solitary pulmonary nodules in patients with human immunodeficiency virus infection. Clin Infect Dis 1997; 24:908-13. [PMID: 9142791 DOI: 10.1093/clinids/24.5.908] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
We assessed 10 patients with human immunodeficiency virus (HIV) infection (nine of whom had AIDS) and solitary pulmonary nodules (SPNs) that were detected on roentgenograms. Five of the patients presented with respiratory symptoms. The etiology of the SPN was determined for eight of these patients: six had infections (hydatidosis, mucormycosis, or infection with Nocardia asteroides, Cryptococcus neoformans, cytomegalovirus, or Pneumocystis carinii), one had non-Hodgkin's lymphoma, and the remaining patient had round atelectasis. Sputum studies were of no diagnostic value in any of these cases. Fiberoptic bronchoscopy with bronchoalveolar lavage and transbronchial biopsy was diagnostic in two of seven cases, and percutaneous transthoracic needle biopsy (PTNB) was diagnostic in one of four cases. Several microorganisms that were not the cause of the SPNs were observed in samples of sputum, bronchoscopic specimens, and PTNB specimens. Thoracotomy was diagnostic in the three cases in which it was performed. We conclude that the management of SPNs in HIV-infected patients is complicated by the low sensitivity and specificity of the diagnostic tests used.
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Affiliation(s)
- F J Martínez-Marcos
- Unit of Infectious Diseases, Hospital Universitario Virgen del Rocío, Seville, Spain
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Cordero E, Lara C, Cañas E, Romero J, Trujillo F, Chinchón I, Pachón J. [Usefulness of cerebral biopsy in focal cerebral lesions in patients with human immunodeficiency virus infection]. Med Clin (Barc) 1996; 107:738-41. [PMID: 9082092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Brain mass lesions (BML) occurred in 10% of patients infected by the human immunodeficiency virus (HIV), as expression of severe and sometimes treatable diseases. However, the management of them is not well established. We analyzed, retrospectively, 26 brain biopsies (22 estereotaxic) in patients with HIV infection and BML to know their usefulness and safety. The inclusion criteria were: Failure of the anti-Toxoplasma empirical treatment, atypical scan appearance for toxoplasmosis, or severe neurological picture. Brain biopsy yielded a diagnosis in 19 patients (73.1%): Progressive multifocal leukoencephalopathy (n = 8; 30.8%), primary central nervous system lymphoma (n = 6; 23.1%), mycobacteriosis (n = 2; 7.7%), toxoplasmosis (n = 2; 7.7%), criptococcosis (n = 1), cryptosporidiosis (n = 1) and HIV-encephalitis (n = 1). In one case there was a multiple diagnosis: mycobacteriosis, toxoplasmosis, and lymphoma. Brain biopsy results decided a change in therapy in 65.4%, the resolution or improvement of the neurological process in 30.8%, and the determination of the prognosis in 30.8%. In 8 cases (30.7%) there were biopsy complications, with secondary mortality in one. Brain biopsy of BML in HIV-infected patients is a diagnostic method with a high overall diagnostic rentability and uncommon non reversible complications, offering the possibility to prescribe a specific and potentially curative treatment.
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Affiliation(s)
- E Cordero
- Departamento de Anatomía Patológica, Hospital Universitario Virgen del Rocío, Sevilla
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Palomino-Nicás J, González E, Arroyo A, Cañas E, Hernanz W, Pachón J. Pyomyositis due to Eubacterium lentum and Streptococcus constellatus from a periodontal source. Clin Infect Dis 1996; 22:176-8. [PMID: 8824994 DOI: 10.1093/clinids/22.1.176] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Affiliation(s)
- J Palomino-Nicás
- Unit of Infectious Diseases, Hospital Universitario Virgen del Rocío, Seville, Spain
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Cañas E, Pachon J, Garcia-Pesquera F, Castillo JR, Viciana P, Cisneros JM, Jimenez-Mejias ME. Absence of effect of trimethoprim-sulfamethoxazole on pharmacokinetics of zidovudine in patients infected with human immunodeficiency virus. Antimicrob Agents Chemother 1996; 40:230-3. [PMID: 8787912 PMCID: PMC163089 DOI: 10.1128/aac.40.1.230] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Pharmacokinetic parameters of zidovudine (ZDV) were not altered in 16 patients receiving concomitant therapy with ZDV and trimethoprim-sulfamethoxazole by oral administration. ZDV areas under the concentration-time curves were (means +/- standard deviations) 1.80 +/- 0.70 and 1.69 +/- 0.64 micrograms.h/ml in the absence and presence of trimethoprim-sulfamethoxazole, respectively. ZDV clearances were 1.57 +/- 0.61 and 1.74 +/- 0.66 liters/h/kg, respectively.
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Affiliation(s)
- E Cañas
- Infectious Diseases Unit, Hospital Universitario Virgen del Rocio, Seville, Spain
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Pachón J, Viciana P, Cisneros JM, García Pesquera F, Castillo JR, Cañas E. [Pharmacokinetic study of zidovudine in parenteral drug addicts with human immunodeficiency virus infection]. Med Clin (Barc) 1993; 100:46-9. [PMID: 8429708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND The aim of this study was to know the pharmacokinetics of zidovudine (ZDV) in steady state in patients with infection by the human immunodeficiency virus (HIV) in whom the risk factor was intravenous drug use. METHODS The study was carried out in 8 patients in stage IV of the Centers for Disease Control (CDC) with no acute intercurrent process, with normal liver and renal function, orally receiving 250 mg of ZDV every 6 hours. Blood samples were taken between 30 and 360 minutes from the last doses taken during fasting. Plasma concentrations of ZDV and glucuronide zidovudine (G-ZDV) were determined by radioimmunoassay with the data being adapted to a monocompartmental pharmacokinetic model. RESULTS The maximum concentration (Cmax) of ZDV was 0.81 +/- 0.38 microgram/ml demonstrating high interindividual variability with values between 0.35 microgram/ml and 1.45 microgram/ml. The mean Cmax of G-ZDV was 1.44 +/- 0.64 microgram/ml. The mean t1/2 of ZDV and G-ZDV was 1.63 +/- 0.75 hours and 1.12 +/- 0.32 hours, respectively, with values oscillating between 0.99 and 3.14 h in the case of ZDV. The area below the curve concentration/time (AUC) of ZDV was 1.43 +/- 0.34 microgram-h/ml and in the case of G-ZDV the AUC was 2.73 +/- 0.91 microgram-h/ml. Total body clearance (Clb) of ZDV was 2.11 +/- 0.64 l/kg/h and the volume of distribution (Vd) of ZDV was 5.6 +/- 1.73 l/kg. CONCLUSIONS The results of this study demonstrate that there is a marked interindividual variability in the pharmacokinetics of zidovudine suggesting the need for adapting dosage to patients weight and monitoring plasma concentration.
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Affiliation(s)
- J Pachón
- Unidad de Enfermedades Infecciosas, Hospital Universitario Virgen del Rocío, Sevilla
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Abstract
OBJECTIVE To study the pharmacokinetics of zidovudine (ZDV) and its glucoronide metabolite (G-ZDV) in a patient with end-stage renal disease in haemodialysis. DESIGN Pharmacokinetics study performed during and between haemodialysis sessions. METHODS The patient was treated with oral ZDV (100 mg every 8 h). Concentrations of ZDV and G-ZDV were measured by radioimmunoassay. A monocompartmental model was used to calculate pharmacokinetic parameters. RESULTS The peak plasma concentrations of ZDV and G-ZDV after drug administration between haemodialysis sessions were 0.57 and 10.01 micrograms/ml, respectively. The half-lives of ZDV and G-ZDV rose to 3.2 and 14.2 h, respectively. The total body clearance for ZDV in the period between haemodialysis sessions (0.44 l/kg/h) was 66% lower than normal values. The ZDV half-life was normalized by haemodialysis, the total body clearance of ZDV increased (1.12 l/kg/h) and the G-ZDV half-life shortened (5.9-7.9 h). Neither G-ZDV accumulation nor derived ZDV toxicity occurred. CONCLUSIONS Our data suggest that ZDV is safe and an efficient drug when administered at a dosage of 100 mg three times daily in patients with end-stage renal disease in haemodialysis sessions, and that ZDV and G-ZDV are cleared by haemodialysis.
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Affiliation(s)
- J Pachon
- Infectious Diseases Unit, Hospital Universitario Virgen del Rocio, Sevilla, Spain
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Cañas E, de Alarcón A, Regordán C, Viciana P. [Babesiosis in an immunocompetent patient]. Rev Clin Esp 1992; 190:45. [PMID: 1546205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Jiménez-Mejías ME, Alfaro MJ, Bernardos A, Cuello JA, Cañas E, Reyes MJ. [Abscess of the psoas: a not-so-rare entity. Analysis of a series of 18 cases]. Enferm Infecc Microbiol Clin 1991; 9:148-53. [PMID: 1863606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
We have studied 18 patients with abscess at the psoas who had a mean age of 43.55 +/- 18.9 years and a predominance of males (77.8%). In nine cases the abscess was secondary to a lumbar discal spondylitis, in 5 cases to a sacroiliitis, in one case to abdominal disorder, and 3 cases the abscess was considered of a primary origin. The etiologic agents were S. aureus (8 cases), E. granulosus (5 cases), M. tuberculosis (3 cases), and B. melitensis (1 case). In one patient the infective agent was not isolated and in two cases the abscesses were infected by E. granulosus and P. aeruginosa. The clinical picture on admission was studied in all cases. Microbiological and pathologic analysis of the abscess allowed to establish the diagnosis in 11 cases (yield: 84.6%). Computerized axial tomography was the most useful imaging technique. Antimicrobial treatment was undertaken in 16 cases. Four patients recovered with pharmacological treatment alone. Surgical treatment was performed in 13 cases. Aspirative punction/drainage was carried in only one patient. The clinical course was favourable in 16 patients (88.9%). Our data indicate that the incidence of abscess of the psoas in cases of intraabdominal infections is low. In our series the incidence of abscesses secondary to hydatidosis is relatively high.
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Affiliation(s)
- M E Jiménez-Mejías
- Unidad de Enfermedades Infecciosas, Departamento de Medicina Interna, Hospital Universitario Virgen del Rocío, Sevilla
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Cañas E, Cararach V, Fortuny A. [Septic abortion. Complications and therapeutic considerations (author's transl)]. Med Clin (Barc) 1980; 74:43-7. [PMID: 7366263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
A study is presented on the incidence and complications of septic abortion in a group of patients admited on the 1st. Obstetric and Gynecologic Clinic of the University of Barcelona during a period of 5 years (1971-1975). Abortion is the cause of admision of 20,2% of patients in the gynecology ward and represents the 12,3% of the overall number of patients during the same period. In 7,8% of the patients admited because of abortion we found the criteria for establishing the diagnosis of septic complication and in 15,2% of those extrapelvic involvement is found, mainly endotoxic shock, acute renal failure and difuse peritonitis. Endocervical cultures were positive in 73% of cases and in 65,7% gram negative germs were isolated, being the most common E. coli. The different clinical patterns are discussed in cases in which anaerobics are implicated and the diagnostic and therapeutic aproaches in the different complications are reviewed particularly in concern to the indications of surgery when this may be the only lifesaving procedure.
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Gamissans O, Cañas E, Cararach V, Ribas J, Puerto B, Edo A. A study of indomethacin combined with ritodrine in threatened preterm labor. Eur J Obstet Gynecol Reprod Biol 1978; 8:123-8. [PMID: 400862 DOI: 10.1016/0028-2243(78)90060-6] [Citation(s) in RCA: 34] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
A prospective and double-blind study was undertaken to compare the effectiveness of two different treatments on two randomized groups of patients with threatened preterm labor. The first treatment consisted of the administration of ritodrine and a placebo; in the second, ritodrine was combined with indomethacin. 22 patients were evaluated in each group. The results obtained for gain in days, number of patients delivered at term, weight of newborns and number of recurrences in each group suggest that treatment with ritodrine and indomethacin is slightly but significantly more effective than treatment with ritodrine and placebo in prolonging pregnancy. No evidence has been found of possible unfavorable vascular effects of indomethacin in the fetus or the newborn.
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Abstract
A study is made of 158 pregnant patients, between 3 and 9 months pregnant, in order to determine, by means of urine culture and ACB, the index of subclinical infections during pregnancy involving the renal parenchyma. The conclusion is reached that these infections occur in 4.42% of cases and out of those cases 57.14% were later shown to have an organic pathology of the excretory tracts.
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