Revista clínica española
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Revista clínica española · Jan 1997
Review Case Reports[Pneumocystis carinii pneumonia in patients with a solid organ transplant: a report of 5 cases].
A report is made here of five patients who underwent solid organ transplantation, were not infected with the human immunodeficiency virus, and suffered Pneumocystis carinii pneumonia while receiving immunosuppressive drugs. The figure represents a prevalence of 0.43% among patients with solid organ transplantation at the Clínica Puerta de Hierro. Some features of this infection are reported in patients without AIDS, both transplanted patients and with other clinical conditions, the possible predisposing factors and the necessity to keep a high suspect index when individuals treated with immunosuppressive drugs present with respiratory symptoms. Likewise, a suggestion is made to consider the use of chemoprophylaxis with cotrimoxazole in these cases.
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Revista clínica española · Jan 1997
Editorial Comment Review[Pneumocystis carinii pneumonia in patients with a solid organ transplant].
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Revista clínica española · Jan 1997
Comparative Study[The metabolic control of insulin-dependent diabetes mellitus and diabetic nephropathy].
Long-term complications of Insulin Dependent Diabetes Mellitus (IDDM) have been associated with several risk factors, particularly the degree of metabolic control and evolution time of the disease. A study was conducted with 219 randomly selected patients with IDDM at our clinic; evolutive, clinical and analytical parameters were assessed and conventional or multiple insulin therapy was evaluated. The classification of glycated hemoglobin (Hb A1c) in quartiles demonstrated a relatively higher incidence of diabetic retinopathy and nephropathy in the upper quartiles versus the lower quartile (p < 0.05). ⋯ The multivariate analysis showed a statistically significant regression model (p < 0.001) for microalbuminuria level in patients with no established nephropathy; in these patients, the evolution time of IDDM and their Hb A1c level showed a positive independent association, and the use of multiple insulin therapy was a protective factor. The regression analysis of microalbuminuria levels compared with glycated hemoglobin in patients with no established nephropathy showed a value for Hb A1c of 9% as a break-point; from this point upwards microalbuminuria levels increased more markedly. The multivariate analysis here presented can help identify the presence of microalbuminuria in the pathological range in patients with IDDM followed at a hospital clinic from feasible clinical variables (evolution time, glycated hemoglobin level, program of insulin therapy used) establishing a metabolic objective which helps prevent the development of this complication.
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Revista clínica española · Nov 1996
Case Reports[Dendriform diffuse pulmonary ossification. Report of 2 cases].
Two cases of diffuse dendriform pulmonary ossification are reported which was diagnosed postmorten. Both patients had a previous history of chronic obstructive pulmonary disease with pneumonic complications. The radiological study was interpreted as pulmonary fibrosis in the first case, an entity which ranks first in the differential diagnosis. In some cases the obtention of highly contrasted X-ray films can be useful for recognizing this are entity.
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Revista clínica española · Oct 1996
[Bacteremia caused by Pseudomonas aeruginosa in patients with AIDS].
Severe infections caused by Pseudomonas aeruginosa are uncommon in patients infected with HIV. These infections are usually recurrent, bear a poor prognosis and their potential for nosocomial transmission is questioned. From May 1991 to December 1994, a total of 2,739 admissions were recorded at the VIH Unit in our hospital. ⋯ With molecular typing techniques homologies over 98% were demonstrated for the two episodes in patient 4 and the episode in patient 3 (very close in time, 1993) and almost 99% between the isolate from patient 7 and the two isolates (identical) from patient 6. The other three isolates had relationship (to themselves and to the other isolates) lower than 97%. Our findings suggest that patient-to-patient transmission of severe infections caused by P. aeruginosa in patients with AIDS.