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Sopena N, Martínez-Vázquez C, Rodríguez-Suárez JR, Segura F, Valencia A, Sabrià M. Comparative Study of the Efficacy and Tolerance of Azithromycin versus Clarithromycin in the Treatment of Community- Acquired Pneumonia in Adults. J Chemother 2013; 16:102-3. [PMID: 15078008 DOI: 10.1179/joc.2004.16.1.102] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Sopeña B, Chamorro A, Gonzalez L, Rivera A, Maure B, Freire M, Martínez-Vázquez C. THU0383 Kikuchi’s disease and systemic lupus erythematous: A systematic literature review. Ann Rheum Dis 2013. [DOI: 10.1136/annrheumdis-2012-eular.2348] [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: 11/04/2022]
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Affiliation(s)
- M T Pérez-Rodríguez
- Internal Medicine Department-Infectious Diseases Unit, Complejo Hospitalario Universitario de Vigo, Vigo, Spain
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Sopeña B, Crespo M, Beiras X, del Campo EG, Rivera A, Gimena B, Maure B, Martínez-Vázquez C. Individualized management of bacteraemia in patients with a permanent endocardial pacemaker. Clin Microbiol Infect 2010; 16:274-80. [DOI: 10.1111/j.1469-0691.2009.02787.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Abstract
Graft intolerance syndrome (GIS) is a common complication developed in failed kidney allografts left in situ when the patients returned to hemodialysis. GIS usually develops within the first 6 months after immunosuppression has been withdrawn. When medical treatment has failed, transplantectomy is the conventional therapy. Nevertheless, in recent years, transvascular ethanol embolization has been reported as an effective, safe, and less invasive technique than transplantectomy for the management of patients with GIS. Although infrequent, the most severe complication is infection of the graft or surrounding tissues, which usually appears in the first weeks after the procedure. We present the first case of late infection of an embolized renal graft, more than 2 years after embolization.
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Affiliation(s)
- M T Pérez Rodríguez
- Internal Medicine Department, Hospital Universitario Xeral-Cíes of Vigo, Pontevedra, Spain
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Vaqueiro Rodríguez I, Martínez-Vázquez C, Martínez-Cueto P, Sopeña Pérez-Argüelles B, Portela Orjales D. Utilidad de la resonancia magnética con espectroscopia para el diagnóstico no invasivo del tuberculoma cerebral. Rev Clin Esp 2009; 209:405-6. [DOI: 10.1016/s0014-2565(09)72349-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Argibay A, Sopeña B, Maure B, Pazos N, Pérez-Rodríguez M, Martínez-Vázquez C. La clave estaba en la historia clínica. Rev Clin Esp 2008; 208:367-8. [DOI: 10.1157/13124321] [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: 11/21/2022]
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Sopeña B, Rivera A, Rodríguez-Domínguez M, Rodríguez-Rodríguez M, Argibay A, Maure B, Gimena B, Martínez-Vázquez C. [Complications related with cocaine abuse that required hospital admission]. Rev Clin Esp 2008; 208:12-7. [PMID: 18221656 DOI: 10.1157/13115002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Although cocaine abuse is an increasingly important medical problem, many manifestations of its toxicity are not well understood. The aim of this study is to review the most serious clinical manifestations related to cocaine abuse. PATIENTS AND METHOD We reviewed the medical records of all patients over 16 years of age admitted to the hospital from January 1994 to December 2005 where cocaine abuse was recorded in their clinical history. RESULTS A total of 170 patients, with 188 episodes and 268 pathologic manifestations related to cocaine abuse were included. Thirty two out of the 170 patients (18.8%) were females. Mean age was 33 +/- 11 years, with no significant difference between males and females. A total of 88.8% were smokers, 70% had alcohol abuse and 67.3% had other illegal drug abuses. The more frequent reason for their hospitalization was: pulmonary infection (29.6%), bronchial hyperreactivity (14%), acute psychotic attack related to drugs (12%), ischemic heart disease (10%), infectious endocarditis (7.8%), cerebrovascular disease (8.6%), seizures (6.2%) and severe abdominal complications (2.3%). Eight patients died (6.25%). The association with cocaine was only suspected in 46% of the toxic manifestations. CONCLUSIONS Several clinical manifestations are associated to cocaine abuse and its consumption causes potentially fatal complications. The integral treatment of these patients could be improved if these complications are kept in mind.
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Affiliation(s)
- B Sopeña
- Servicio de Medicina Interna, Complexo Hospitalario Universitario de Vigo, Pontevedra, Spain.
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Maure B, Martínez-Vázquez C, Argibay A, Pérez-Veloso M, Rodríguez Fernández MJ, Sopeña B. Linezolid in Postneurosurgical Infections. Infection 2008. [DOI: 10.1007/s15010-008-9171-z] [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: 10/22/2022]
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Maure B, Martínez-Vázquez C, Argibay A, Pérez-Veloso M, Rodríguez Fernández MJ, Sopeña B. Linezolid in postneurosurgical infections. Infection 2007; 36:82-3. [PMID: 18165859 DOI: 10.1007/s15010-007-7171-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2007] [Accepted: 08/16/2007] [Indexed: 11/24/2022]
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Fernández-Villar A, Sopeña B, García J, Gimena B, Ulloa F, Botana M, Martínez-Vázquez C. Hepatitis C virus RNA in serum as a risk factor for isoniazid hepatotoxicity. Infection 2007; 35:295-7. [PMID: 17646919 DOI: 10.1007/s15010-007-6125-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2006] [Accepted: 01/30/2007] [Indexed: 10/23/2022]
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Martínez-Vázquez C, Sopeña B, Oliveira I, Bouzas R, Encisa J, Ocampo A, Gallego C, Bordón J. Infección asociada a prótesis vascular: manejo exitoso sin retirada de prótesis. Rev Clin Esp 2007; 207:317-21. [PMID: 17662195 DOI: 10.1157/13107942] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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: 11/21/2022]
Abstract
INTRODUCTION Removal of graft with intravenous antibiotics is traditionally considered the most effective treatment of vascular graft-associated infections. However, an increasing number of reports suggests that this complication can be effectively treated without graft removal. METHODS A prospective study to evaluate the outcome of conservative management of vascular graft-associated infection seen in our center was performed. The diagnosis of graft-associated infection was based on microbiological tests, and imaging studies. In our study, patients were hemodynamically stable with functioning vascular graft as per clinical and imaging evaluations. Conservative management included antibiotic treatment and local debridement without removal of vascular graft. RESULTS Fourteen patients with vascular graft-associated infection were enrolled in our study. Eleven out of 14 patients (78.6%) responded successfully to conservative management. Treatment failure was reported in 3 patients, 2 of whom required graft removal. After a two-year follow-up, these 14 patients were clinically stable without recurrence of infection. CONCLUSIONS Our study has revealed that conservative management of vascular graft-associated infection seems to be effective and should be considered in hemodynamically stable patients with functioning vascular graft.
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Affiliation(s)
- C Martínez-Vázquez
- Unidad de Enfermedades Infecciosas, Hospital Xeral-Cíes, Vigo, Pontevedra, Spain.
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Gimena B, Sopeña B, Sousa J, Albajar-Viñas P, González-Mediero G, Román F, Martínez-Vázquez C. Dolor torácico y eosinofilia periférica. Rev Clin Esp 2007; 207:93-4. [PMID: 17397572 DOI: 10.1157/13100205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Affiliation(s)
- B Gimena
- Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Complexo Hospitalario Universitario de Vigo, Departamento de Medicina, Facultad de Medicina, Universidad de Santiago de Compostela, Spain
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Argibay Filgueira AB, Maure Noia B, Lamas Domínguez P, Martínez-Vázquez C. [Retroperitoneal hematoma with femoral neuropathy, conservative or surgical approach?]. An Med Interna 2006; 23:199. [PMID: 16900600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
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Argibay Filgueira AB, Maure Noia B, Lamas Domínguez P, Martínez-Vázquez C. [Pseudoaneurysm of splenic artery as complication of pancreatitis]. An Med Interna 2006; 23:197-8. [PMID: 16903010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
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Martínez-Vázquez C, Pérez S, Bordon J, Ordi-Ros J, Ribera A, López A. [Pulmonary hemorrhage and anti-phospholipid syndrome]. Rev Clin Esp 2004; 204:528-31. [PMID: 15456604 DOI: 10.1157/13066176] [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: 11/21/2022]
Abstract
The presence of anti-phospholipid antibodies (anticardiolipin antibodies and lupus anticoagulant) associated to venous and/or arterial thrombotic phenomena and fetal losses define the anti-phospholipid syndrome. On rare occasions severe hypoprothrombinemia associated with this disease as a cause of hemorrhagic manifestations has been described. In addition very few cases of alveolar hemorrhage in anti-phospolipid syndrome (APS) have been described, being this complication usually related to microthrombosis and/or capillaritis of pulmonary vessels. We describe two patients without previous clinical manifestations of anti-phospholipid syndrome that showed pulmonary hemorrhage with anticardiolipin antibodies positivity. The first of them, a 33-year-old male, began his disease with low prothrombin time and the presence of antiprothrombin antibodies. In the biopsy by thoracoscopy the presence of pulmonary hemorrhage without capillaritis nor thrombotic phenomena was demonstrated, becoming evident certain clinical improvement and normalization of the prothrombin time after receiving immunosuppressive treatment but with persistence of the pulmonary hemorrhage 5 years later. The second case, a 89-year-old male, began his condition with bilateral lung infiltrates and hemoptysis, anticardiolipin antibodies positivity, and thrombopenia, with recurrence of the condition 1 year later. After other etiological possibilities were ruled out, and despite hemorrhagic trait in both patients, we consider that they should be in the clinical context of the anti-phospholipid syndrome, although at this time they did not meet the criteria recognized in order to diagnose this disease. Within the ampliable clinical spectrum of the anti-phospholipid syndrome we should take into account the pulmonary hemorrhage.
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Affiliation(s)
- C Martínez-Vázquez
- Servicio de Medicina Interna, Complejo Hospitalario Xeral-Cíes, Universidad de Santiago de Compostela
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Sopeña B, Rodríguez Regal A, Rivera A, Zulaica A, De La Fuente J, Martínez-Vázquez C. [A 55-year-old male with Raynaud's phenomenon, cutaneous lesions and focal seizures]. Rev Clin Esp 2004; 204:171-2. [PMID: 15025987 DOI: 10.1157/13058833] [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: 11/21/2022]
Affiliation(s)
- B Sopeña
- Servicios de Medicina Interna, Complexo Hospitalario Xeral-Cies, Vigo
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Sopeña B, Rodríguez Regal A, Zulaica A, de la Fuente J, Martínez-Vázquez C, Rivera A. Varón de 55 años con fenómeno de Raynaud, lesiones cutáneas y crisis focales. Rev Clin Esp 2004. [DOI: 10.1016/s0014-2565(04)71425-3] [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: 11/26/2022]
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Martínez-Vázquez C, González Mediero G, Núñez M, Pérez S, García-Fernaández JM, Gimena B. [Strongyloides stercoralis in the south of Galicia]. An Med Interna 2003; 20:477-9. [PMID: 14755904] [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] [Subscribe] [Scholar Register] [Indexed: 04/28/2023]
Abstract
Strongyloides stercoralis is the only parasite which can produce a chronic illness in humans, being through autoinfection. This nematode can also provoke death when patient's immunologic state deteriorates producing a massive hyper infection. The first patient with strongyloidiasis who has always lived in the Galician South area is described. The clinical picture consisted of unspecific cutaneous lesions and abdominal pain with severe peripheral eosinophilia (> 20,000/ml. The diagnosis was carried out observing the larvae in the fecal examination and was confirmed with a culture. Treatment with albendazole failed and the healing was reached with ivermectin. We must consider the possibility of strongyloidiasis because misdiagnosing these patients as eosinophilic gastroenteritis there would be a higher risk of hyperinfection if they are treated with corticosteroids.
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Affiliation(s)
- C Martínez-Vázquez
- Sección de Microbiología y Parasitología, Hospital Xeral-Cíes, Unidad de Enfermedades Infecciosas, Universidad de Santiago, Vigo
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Limeres-Posse J, Tomás-Carmona I, Fernández-Feijoo J, Martínez-Vázquez C, Castro-Iglesias A, Diz-Dios P. [Cerebral abscesses of oral origin]. Rev Neurol 2003; 37:201-6. [PMID: 12938049] [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: 03/04/2023]
Abstract
INTRODUCTION It has been suggested that between 3% and 13% of the cerebral abscesses (CA) are presumably associated to oral infections or dental procedures. AIM Determine the prevalence of CA of oral origin, discussing their clinical and microbiological characteristics. PATIENTS AND METHODS Retrospectively, 54 cases of CA diagnosed in 3 hospitals of Galicia between 2001 and 2002 were reviewed. RESULTS A presumed oral portal of entry was recorded in 6 patients (11.1%); 4 cases were associated to oral infections and the remaining 2 had received dental treatment in the months prior to the onset of symptoms. Half of the patients showed irrelevant medical record, 2 had had previous extracranial abscesses and 1 presented a type A immunoglobulin deficiency. In 4 cases, the microbiological analysis was positive and typical oral bacteria (Streptococcus viridans and Peptostreptococcus spp.) were identified. CONCLUSIONS The results of this study suggest that a significant number of CA are probably of oral origin. In consequence, to maintain a good oral health status is important and specific prophylactic measures before any dental procedure should be applied, especially in patients with risk recognized factors.
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Affiliation(s)
- J Limeres-Posse
- Facultad de Medicina y Odontología, Universidad de Santiago de Compostela, Santiago de Compostela
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Rodríguez Carnero S, Martínez-Vázquez C, Potel Alvarellos C, Alvarez Fernández M, Prieto González JM, Noya García M, de la Fuente Aguado J, Sopeña Argüelles B. [Lack of human herpesvirus type 6 DNA in CSF by nested PCR among patients with multiple sclerosis]. Rev Clin Esp 2002; 202:588-91. [PMID: 12392645] [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: 02/26/2023]
Abstract
BACKGROUND The etiology of multiple sclerosis (MS) is currently unknown. Different viruses have tentatively been involved as causative agents of MS that would trigger an autoimmune response leading to demyelination plaques. There is controversy regarding the role that the human herpesvirus 6 (HHV-6) might play in this condition, and high antibody titers have been detected to HHV-6. HHV-6 DNA has also been detected by PCR both in blood and cerebrospinal fluid by means of the Polymerase Chain Reaction (PCR). Immunohistochemistry studies were performed with histologic specimens from the white matters of patientes with MS. All this has led some authors to incriminate this virus as the triggering etiologic agent of this disease. PATIENTS AND METHODS CSF specimens from 23 patients with Relapsing-Remitting MS were studied. The CSF specimens from 23 patients undergoing rachianesthesia were used as controls, and none of them had neurologic disorders. A nested PCR was performed in the collected specimens to detect specific DNA sequences of HHV-6. RESULTS No DNA sequences of HHV-6, EBV, VZV, CMV and HSV were detected in the tested specimens. CONCLUSIONS No HHV-6 DNA sequences were detected from CSF specimens of patients with MS. Further investigations on the association between HHV-6 and MS should be performed to elucidate the role of HHV-6 in the pathogenesis of this disease.
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Affiliation(s)
- S Rodríguez Carnero
- Unidad de Enfermedades Infecciosas-Servicio de Medicina Interna. Complexo Hospitalario Xeral-Cies. Vigo. Pontevedra. Spain
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Martínez-Vázquez C, Nodar Germiñas A, Conde Alonso C, López Domínguez A, Seijas Ares M. [Cranial granulomatous hypertrophic pachymeningitis]. An Med Interna 2002; 19:98-9. [PMID: 11989109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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Martínez-Vázquez C, Nodar A, Crespo M, Seijas M, Cid D, López A, Bouzas R. [Mycotic pseudoaneurysm caused by Mycobacterium tuberculosis]. An Med Interna 2001; 18:594-6. [PMID: 11862772] [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] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Mycobacterium tuberculosis can involve any organ of the body, including the arteries. Usually the mycobacteria infects the arterial wall spreading from a contiguous foci. We report a case of tuberculous pseudoaneurysm involving the iliac artery clinically manifested as fever of unknown origin. The diagnosis relied on abdominal CT-scanning. Tuberculous etiology was confirmed postoperatively by microbiologic and microscopic study. The antituberculous therapy was early started, but the patient died three months later as a consequence of a non-infectious abdominal aortic rupture. Clinicians should consider tuberculous etiology when the diagnosis of mycotic pseudoaneurysm is being entertained.
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Affiliation(s)
- C Martínez-Vázquez
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Complejo Hospitalario Xeral-Cíes Vigo
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Martínez-Vázquez C, Seijas M, Ocampo A, López A, Oliveira I, Sopeña B, de la Fuente J, Freita S. [Pneumothorax in patients infected by the human immunodeficiency virus]. An Med Interna 2001; 18:521-4. [PMID: 11766281] [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] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE Patients with HIV who develop pneumothorax have been previously described. Pneumocystis carinii pneumonia (PCN) is the leading cause of this complication, but infection by other pulmonary microorganism, inhaled pentamidine therapy and lung invasive manoeuvres have also been associated with pneumothorax in HIV infected patients. METHOD We review the most relevant clinical aspects of pneumothorax in HIV-infected persons, gathered in our hospital along eight years, before HAART therapy was started. During this time, 97 patients with PCN were diagnosed and 148 patients received prophylaxis with inhaled pentamidine. Only 14 episodes of pneumothorax in 13 patients, were recorded. In ten occasions pneumothorax was related to pulmonary invasive manoeuvres, pulmonary infections were found in three and was considered spontaneous in one. The pulmonary invasive manoeuvres were: subclavia vein catheterisation in six cases (one of them was diagnosed of proved PCN and the other has pneumococcal pneumonia); transbronchial biopsy in one patient (also with proved PCN), knife chest trauma in two cases and after fine needle aspiration of an axillary lymph node in one patient. RESULTS The pulmonary infections associated with pneumothorax in three patients were: proved PCN (this patient was the only one in the group with inhaled pentamidine prophylaxis who developed pneumothorax), active pulmonary infection by mycobacterium tuberculosis and Pseudomonas aeruginosa pneumonia. A drainage chest tube was placed in 12 patients with complete resolution in nine. In the other two patients pleurodesis was necessary and surgical repair was carried out in the other one (who had pulmonary tuberculosis). During the follow up six patients died (median time to death: 7 months). Among patients who died, five had pulmonary infections when the pneumothorax was diagnosed: PCN in three cases, pulmonary tuberculosis and pseudomonas pneumonia in the other two; all of them with less than 100 CD4 lymphocytes. CONCLUSIONS Pneumothorax is frequent in HIV-infected patients with PCN, but other lung infections and, above all pulmonary invasive manoeuvres, can cause this complication. In our experience, HIV-infected patients who develop pneumothorax have a bad prognosis.
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Affiliation(s)
- C Martínez-Vázquez
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Complejo Hospitalario Xeral-Cíes, Universidad de Santiago de Compostela, Vigo
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Sopeña B, García-Tejedor JL, de la Fuente J, Rivera A, Martínez-Vázquez C. [Giant cell pulmonary carcinoma in a patient with HIV infection]. An Med Interna 2001; 18:336-7. [PMID: 11503583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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Martínez-Vázquez C, Martínez Cadilla J, Gil M, Sopeña B, Torres J, Cordeiro E, Seijas M, de la Fuente J, Méndez MJ. [Prevalence of hereditary hemochromatosis among healthy workers. Diagnostic value of transferrin saturation assay]. An Med Interna 2000; 17:628-31. [PMID: 11213576] [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] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
AIM Hereditary hemochromatosis is the most common inherited disorder in white population (2-8 cases per 1000 habitants). Hemochromatosis is characterized by increased intestinal absorption of iron leading to its deposition into multiple organs. An early diagnosis and proper management with frequent phlebotomies are known to improve life expectancy and quality of life. Diagnosis is suggested by an elevated Transferrin saturation (TS) (more than 60%). METHOD Prospective study of the level of TS among 1131 healthy workers, who came to the Security and Hygiene Official Centre for their annual revision had been undertaken. RESULTS Twenty-wo workers had high TS; in 10 of them the increase of TS was confirmed on repeated determinations. Liver biopsy was performed in six (and refused by the other four), eventually a diagnosis of hemochromatosis was confirmed in three (in-group prevalence of 2.6 per 1000 people). CONCLUSIONS In our experience, TS is the most appropriate initial screening test for detecting hereditary hemochromatosis in a normal population.
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Affiliation(s)
- C Martínez-Vázquez
- Servicio de Medicina Interna y Aparato Digestivo, Complejo Hospitalario Xeral-Cíes, Vigo, Universidad de Santiago, Vigo
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Bordón J, Martínez-Vázquez C, de la Fuente-Aguado J, Sopeña B, Ocampo-Hermida A, Nuñez-Torrón J, Rodríguez-Sousa T, Alvarez-Fernandez M, del Blanco T. Response to standard syphilis treatment in patients infected with the human immunodeficiency virus. Eur J Clin Microbiol Infect Dis 1999; 18:729-32. [PMID: 10584901 DOI: 10.1007/s100960050387] [Citation(s) in RCA: 9] [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: 11/26/2022]
Abstract
In a study designed to evaluate the efficacy of penicillin in HIV-infected patients with syphilis and to determine the clinical and laboratory responses after treatment, 13 patients with HIV infection and syphilis were assessed at enrollment and at the last follow-up examination (median time of 21 months). The Venereal Diseases Research Laboratory (VDRL) test, the Treponema pallidum hemaglutination test, and leukocyte counts in cerebrospinal fluid were evaluated both at enrollment and at the last follow-up visit, and the polymerase chain reaction for Treponema pallidum DNA and the rabbit infectivity test were performed on cerebrospinal fluid samples at the last follow-up visit. Primary syphilis was confirmed in four patients, latent syphilis in five, and neurosyphilis in four. After penicillin treatment, all patients were asymptomatic. The serum rapid plasma reagin test became negative in five patients, and titers declined in eight. The VDRL test, Treponema pallidum DNA, and the rabbit infectivity test were negative in all 13 patients. Except for one patient whose serological titer was slow to decline, all patients had good clinical and serological responses to penicillin. In certain settings, factors other than penicillin treatment failure should be considered in HIV-infected patients with suspected relapse of syphilis.
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Affiliation(s)
- J Bordón
- Unit of Infectious Diseases, Hospital Xeral of Vigo, University of Santiago de Compostela, Spain.
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Freire MC, Sopeña B, Méndez MX, Crespo M, de la Fuente J, Martínez-Vázquez C. [Mediastinal adenopathies and peripheral arteritis]. Enferm Infecc Microbiol Clin 1999; 17:39-40. [PMID: 10069112] [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: 02/11/2023]
Affiliation(s)
- M C Freire
- Servicio de Medicina Interna, Complexo Hospitalario Xeral-Cíes, Vigo, Pontevedra
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Martínez-Vázquez C, Fernández-Ulloa J, Bordón J, Sopeña B, de la Fuente J, Ocampo A, Rubianes M. Candida albicans endophthalmitis in brown heroin addicts: response to early vitrectomy preceded and followed by antifungal therapy. Clin Infect Dis 1998; 27:1130-3. [PMID: 9827257 DOI: 10.1086/514972] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.8] [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: 11/03/2022] Open
Abstract
The management of Candida albicans endophthalmitis in intravenous drug abusers (IVDAs) has yet to be established. Early vitrectomy was previously reported as a promising treatment for C. albicans endophthalmitis. In our series, C. albicans endophthalmitis was diagnosed for 15 IVDAs. Funduscopic examinations confirmed severe vitritis in 12 patients and chorioretinitis in three. Blood and vitreal cultures were positive for C. albicans for seven and eight patients, respectively. Patients with vitritis received antifungal therapy before and after vitrectomy. Amphotericin B or fluconazole therapy was given according to the physician's preference. Vitrectomy was defined as early if it was performed within 1 week after the diagnosis of vitritis. All seven patients who underwent early vitrectomy had a favorable response without complications. Two of three patients who underwent late vitrectomy developed blindness or scotoma. Blindness was also described in two patients with vitritis who did not undergo vitrectomy. Early vitrectomy preceded and followed by antifungal therapy seems to be appropriate management of vitritis in IVDAs.
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Affiliation(s)
- C Martínez-Vázquez
- Infectious Diseases Unit, Hospital Xeral of Vigo, Santiago de Compostela Medical School, Spain
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Sopeña B, de la Fuente J, Méndez MX, Mayo R, Rodríguez Martín C, Cid D, Martínez-Vázquez C. [Young woman with tuberous sclerosis and spontaneous pneumothorax]. Rev Clin Esp 1998; 198:331-2. [PMID: 9658919] [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: 02/08/2023]
Affiliation(s)
- B Sopeña
- Servicio de Medicina Interna, Complexo Hospitalario Xeral-Cíes, Vigo
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Sopeña B, Barbazán C, de la Fuente J, Méndez MX, Martínez-Vázquez C. [Reactive arthritis and erythema multiforme caused by Salmonella dublin]. Enferm Infecc Microbiol Clin 1997; 15:442-3. [PMID: 9424135] [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: 02/05/2023]
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Martínez-Vázquez C, Hughes G, Bordon J, Alonso-Alonso J, Anibarro-Garcia A, Redondo-Martínez E, Touza-Rey F. Histiocytic necrotizing lymphadenitis, Kikuchi-Fujimoto's disease, associated with systemic lupus erythemotosus. QJM 1997; 90:531-3. [PMID: 9327032 DOI: 10.1093/qjmed/90.8.531] [Citation(s) in RCA: 74] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Histiocytic necrotizing lymphadenitis, Kikuchi-Fujimoto's Disease (KFD), is a condition rarely associated with systemic lupus erythematosus (SLE). The diagnosis of KFD can precede, postdate or coincide with the diagnosis of SLE. Lymphadenopathy is a common clinical presentation of KFD and SLE, and is histologically indistinguishable in both conditions. We describe two cases of KFD associated with SLE. The diagnosis of KFD in one case was made several years before the diagnosis of SLE, and the other was simultaneous. Both showed large lymphadenopathy, but neither fever nor neutropenia. Lymph-node biopsy showed necrosis, with proliferation of histiocytes and immunoblasts, paucity of neutrophils and absence of hemathoxilin bodies. Both patients responded favourably to steroid treatment. Patients with KFD should be assessed for SLE and have long-term follow-up checking for development of SLE. KFD should be ruled out in SLE flare-up accompanied by lymphadenopathy.
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Affiliation(s)
- C Martínez-Vázquez
- Infectious Diseases Unit, Hospital Xeral of Vigo, Santiago de Compostela Medical School, Spain
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Sopeña B, Martínez-Vázquez C, Fernández-Rodríguez CM, de la Fuente J, Rivera A, Rodríguez M, Gómez MC, Prieto J. Serum angiotensin converting enzyme and C4 protein of complement as a combined diagnostic index in alcoholic liver disease. Liver 1996; 16:303-8. [PMID: 8938630 DOI: 10.1111/j.1600-0676.1996.tb00750.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Diagnosis of liver cirrhosis relies on hepatic biopsy. So far, attempts have failed to achieve a serologic test that differentiates cirrhosis from other hepatic conditions. The aim of this work was to assess the diagnostic value of the ratio of serum angiotensin converting enzyme activity (SACE) and the levels of protein C4 of serum complement (SACE/C4) in differentiating cirrhotic from noncirrhotic alcoholic liver diseases. In this study, 68 active alcoholic patients (17 with fatty liver or minimal changes, 11 with acute alcoholic hepatitis and 40 with cirrhosis) were included. Twenty healthy subjects were studied as a control group. Liver biopsy was performed in all patients. SACE levels were significantly higher in the group with cirrhosis when compared with the group of patients without cirrhosis and the control. On the other hand, serum C4 level decreased as liver damage progressed. SACE values above 25 IU/l had a sensitivity of 92.5 percent (95 percent confidence interval, 87.5 to 97.5) and a specificity of 79 percent (95% percent confidence interval, 70.5 to 87.5), in detecting those patients with liver cirrhosis. The sensitivity further increased to 95 percent (95 percent confidence interval, 90.5 to 99.5) and the specificity to 100 percent when the SACE/C4 ratio was used and a cutoff point of 145 was chosen. To conclude, in alcoholics SACE is specifically elevated in patients with cirrhosis, and the SACE/C4 ratio is a excellent biochemical index for the diagnosis of cirrhosis in alcoholic patients.
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Affiliation(s)
- B Sopeña
- Service of Internal Medicine, Hospital Xeral-Cies of Vigo, Spain
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Méndez Piñeiro MX, Sopeña B, Rivera A, Carreró J, Freire M, Martínez-Vázquez C. [Slow-resolving pneumonia in an 86-year-old man]. Rev Clin Esp 1996; 196:721-2. [PMID: 9005478] [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: 02/03/2023]
Affiliation(s)
- M X Méndez Piñeiro
- Servicio de Medicina Interna, Complexo Hospitalario Xeral-Cíes, Vigo, Pontevedra
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de la Fuente-Aguado J, Bordón J, Moreno JA, Sopeña B, Rodriguez A, Martínez-Vázquez C. Parkinsonism in an HIV-infected patient with hypodense cerebral lesion. Tuber Lung Dis 1996; 77:191-2. [PMID: 8762858 DOI: 10.1016/s0962-8479(96)90038-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
A 49-year-old man presented with fever and parkinsonism. Examination of cerebrospinal fluid confirmed tuberculous meningitis. Cerebral computerized tomography scan revealed hypodense lesions and human immunodeficiency virus tests were positive. The patient's clinical picture and parkinsonism were improved with tuberculosis treatment.
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Sopeña B, Touza F, Freire M, Martínez-Vázquez C. [Chronic meningococcemia: a rare cause of migratory arthritis]. An Med Interna 1996; 13:206-7. [PMID: 8688487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
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de la Fuente Aguado J, Moreno Sanjuán JA, Martínez-Vázquez C, Estévez Diz A, Fernández Villar A, Sopeña Pérez-Argüelles B. [Muscle pain and swelling in a HIV-positive patient]. Rev Clin Esp 1995; 195:811-2. [PMID: 8560042] [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: 01/31/2023]
Affiliation(s)
- J de la Fuente Aguado
- Servicio de Medicina Interna, Unidad de Enfermedades Infecciosas, Complejo Hospitalario Xeral-Cies, Vigo
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Bordón J, Martínez-Vázquez C, Alvarez M, Miralles C, Ocampo A, de la Fuente-Aguado J, Sopeña-Perez Arguelles B. Neurosyphilis in HIV-infected patients. Eur J Clin Microbiol Infect Dis 1995; 14:864-9. [PMID: 8605899 DOI: 10.1007/bf01691492] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.0] [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: 01/31/2023]
Abstract
To determine the prevalence and the clinical and serological findings of neurosyphilis in HIV-infected patients, Treponema pallidum hemagglutination (TPHA) tests, CD4+ lymphocyte counts and determination of rapid plasma reagin (RPR) titers were performed in 972 HIV-infected patients over a period of 3.5 years. Patients were scored according to the Centers for Disease Control's classification for HIV infection. Reactive serum syphilis tests and positive cerebrospinal fluid (CSF)-Venereal Disease Research Laboratory (VDRL) tests, with or without clinical symptoms, were used as the criteria for diagnosis of neurosyphilis. The TPHA test was positive in 31 patients, representing 3.1% of all HIV-infected patients included in the study. Of these, 13 were intravenous drug addicts, 14 were homosexuals and 4 were heterosexuals. Diagnosis of syphilis was concurrent with HIV infection in 19 patients, prior to HIV infection in 6 patients and after HIV infection in 6 patients. CSF examinations were performed in 28 of the 31 (90.3%) patients with serologically evident syphilis. Four patients had positive CSF-VDRL tests with pleocytosis (23.5% of untreated syphilis patients in whom CSF was examined), three of whom reported mild headache, which was considered a doubtful manifestation of neurosyphilis. Patients with syphilis diagnosed and treated prior to diagnosis of HIV infection did not have evidence of neurosyphilis. Seven patients had pleocytosis with a negative CSF-VDRL test, without any clinical manifestations of neurosyphilis. There was no significant difference in the mean CD4+ lymphocyte count between patients with and without neurosyphilis (p = 0.5). RPR titers in neurosyphilis patients were greater than those in patients previously treated for syphilis and in those with pleocytosis only (p = 0.046 and 0.036, respectively). All neurosyphilis patients had an RPR titer > 1:8. After therapy, neurosyphilis patients had negative CSF-VDRL tests with a lower level of pleocytosis. The prevalence of neurosyphilis was 0.4% in HIV-infected patients and 23.5% in HIV-infected patients with untreated syphilis. This high prevalence of neurosyphilis warrants CSF examination in HIV-infected patients with syphilis, regardless of the stage of syphilis.
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Affiliation(s)
- J Bordón
- Infectious Diseases Unit, Hospital Xeral of Vigo, University of Santiago Compostela, Spain
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Martínez-Vázquez C, Bordón J, Rodríguez-González A, de la Fuente-Aguado J, Sopeña B, Gallego-Rivera A, Martínez-Cueto P. Cerebral tuberculoma--a comparative study in patients with and without HIV infection. Infection 1995; 23:149-53. [PMID: 7499003 DOI: 10.1007/bf01793855] [Citation(s) in RCA: 24] [Impact Index Per Article: 0.8] [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: 01/25/2023]
Abstract
The microbiological, clinical and radiological findings of cerebral tuberculomas in four patients with and in five patients without HIV infection were compared. The study was carried out during the last 14 years. The CT scans were analyzed in a blinded fashion. Cerebral tuberculoma in HIV-negative patients was clinically characterized by seizures, while in HIV-positive patients this finding was absent. All four HIV-infected patients had headache and fever and their CSF showed lymphocytic meningitis. Two HIV-negative and three HIV-positive patients had concurrent extracerebral tuberculosis. In HIV-infected patients, the cerebral tuberculoma was a secondary finding of disseminated tuberculosis. In our small patient samples, the cerebral tuberculoma presented as spontaneous hypodense cerebral lesions in all the HIV-positive patients but as a hyperdense cerebral lesion in the HIV-negative patients. Two patients of each group had ring enhancement lesions. Cerebral tuberculoma was diagnosed in about 4 weeks for HIV-positive patients, but took some 16 weeks for HIV-negative patients, the latter being first suspected of having a cerebral tumor or bacterial abscess. Diagnostic craniotomy was thus necessary for the HIV-negative patients. One patient of each group died as a consequence of cerebral tuberculoma, all the remaining patients improved with treatment.
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Affiliation(s)
- C Martínez-Vázquez
- Infectious Disease Unit, Hospital Xeral of Vigo Medical School of Santiago de Compostela University, Spain
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Martínez-Vázquez C, Albo C, Rivera A, Bordón J, Rodríguez A, Sopeña B, de la Fuente J, Boullosa RG. [Primary antiphospholipid syndrome. Clinical course features of 24 cases]. Rev Clin Esp 1994; 194:164-9. [PMID: 8008952] [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: 01/28/2023]
Abstract
OBJECTIVES Describe the clinico-evolutionary characteristics of cases of primary antiphospholipid syndrome (PAPLS) diagnosed at our center. PATIENTS AND METHODS Retrospective study of all patients with circulating anticoagulant type lupus (AL) (62 patients) and/or anticardiolipin antibodies (ACLA) found in our center since 1981 and 1988, respectively. TTPA, Kaolin's test (KT), and Russel's viper venom time (RVVT) and ACLA type IgG and IgM by ELISA: Only those patients meeting the criteria for PAPLS are included. RESULTS Twenty-four patients were diagnosed with PAPLS: Eleven patients were from the enlarged TTPA group, 11 of the total with positive ACLA, and two by KT and abnormal RVVT. As for gender, 18 were women. In the past three years, 19 patients were diagnosed. The diagnostic criteria were from the very beginning: venous thrombosis in nine patients, arterial thrombosis in four, aborted repetitions in three, and plateletopenia in eight. Six patients presented pulmonary thromboembolism, the cause of death in one patient. Thrombopenia was manifested in the evolutionary course of 14 patients, only one of which being severe. Two patients have died (one of them from neoplasia), and two others have had antiphospholipid antibodies become negative. Seven patients remain without treatment, the others undergoing anti-aggregating or anti-coagulant treatment. CONCLUSIONS Plateletopenia, alone or accompanied by other symptoms, is the most common alteration of PAPLS in our area, followed by venous thrombosis which caused death by pulmonary thromboembolism in one patient. Arterial thrombotic events and aborted repetitions are by no means infrequent.
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Sopeña B, Martínez-Vázquez C, de la Fuente J, Fernández C, Rivera A, Rodríguez MA, Rodríguez A. [Serum levels of immunoglobulins and complement in alcoholic liver disease]. Rev Clin Esp 1993; 193:419-23. [PMID: 8115693] [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: 01/28/2023]
Abstract
The presence of high serum concentrations of immunoglobulins and hypocomplementemia is commonly observed in alcoholic patients; however, the mechanism behind their production is unknown. We studied 70 subjects (52 alcoholics and 18 healthy controls) prospectively. All the patients were active drinkers who consumed more than 100 gr of ethanol daily for at least 10 years. A biopsy of the liver was performed for all the subjects, along with immunoglobulins, C3, C4, CH100 and tests of liver function. Of the 52 alcoholics in the study, 20 showed minimal changes in hepatic steatosis (group II), 6 isolated severe alcoholic hepatitis (group III), 11 cirrhosis of the liver without alcoholic hepatitis (group IV), and 15 cirrhosis with alcoholic hepatitis (group V). There were no significant differences between the various groups according to age or quantity and duration of intake. The highest concentrations of immunoglobulins was observed in those with cirrhosis of the liver (p < 0.001) regardless of the degree of inflammation. The best correlation was found between IgA and liver histology (r = 0.64; p < 0.001). Hypocomplementemia was a factor only in those patients belonging to histological groups IV and V. Both the immunoglobulins and the complement proteins were narrowly correlated with the tests of liver function, and its alterations were more pronounced in patients with cirrhosis in Child's stage C. We conclude that the hypergammaglobulinemia and hypocomplementemia observed in the alcoholic patients are conditioned fundamentally by the degree of deterioration in liver function, indicated by cirrhosis of the liver upon presentation.
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Affiliation(s)
- B Sopeña
- Unidad de Enfermedades Infecciosas, Hospital Xeral de Vigo, Pontevedra
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Pena González A, Dubois A, Fernández R, Martínez-Vázquez C. [Renal insufficiency induced by captopril in a patient with bilateral renal artery stenosis]. Rev Clin Esp 1986; 178:469-70. [PMID: 3526430] [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: 01/06/2023]
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