Medicine (MEDICINE)

Publications in this journal

• Article: On the Pathogenesis of Tetany

  W G MacCALLUM
  Medicine 08/2012; 3(2):137-163.
• Article: A Review of the Investigations Concerning the Etiology of Measles

  ANDREW WATSON SELLARDS
  Medicine 08/2012; 3(2):99-136.
• Article: Pathology

  JOSEPH C. AUB, LAWRENCE T. FAIRHALL, A S MINOT, PAUL REZNIKOFF
  Medicine 08/2012; 4(1-2):113-126.
• Article: The Transportation and Deposition of Lead in the Body

  JOSEPH C. AUB, LAWRENCE T. FAIRHALL, A S MINOT, PAUL REZNIKOFF
  Medicine 08/2012; 4(1-2):25-43.
• Article: Relativos betuneen odon genio infecciones and infective endocarditis

  Bascones-MartinezA.Muñoa-Corcuera M. Bascones-Ilundain J
  Medicine 01/2012;
• Article: Patologia inmunologica de localizacion bucal

  Antonio Bascones-Martı´nez, Marta Mun˜oz-Corcuera y Cristina Bascones-Ilundain
  Medicine 01/2012;
• Article: Pneumonia Complicating Pandemic (H1N1) 2009: Risk Factors, Clinical Features, and Outcomes

  Diego Viasus, José Ramón Paño-Pardo, Jerónimo Pachón, Melchor Riera, Francisco López-Medrano, Antoni Payeras, M. Carmen Fariñas, Asunción Moreno, Jesús Rodríguez-Baño, José Antonio Oteo, Joaquín Martínez-Montauti, Julián Torre-Cisneros, Ferrán Segura, Francesc Gudiol, Jordi Carratalà
  [show abstract] [hide abstract]
  ABSTRACT: We performed an observational analysis of a prospective cohort of adults hospitalized for pandemic (H1N1) 2009 at 13 Spanish hospitals, from June to November 2009, to determine the risk factors, clinical features, and outcomes of pneumonia. Of 585 patients requiring hospitalization, chest radiography was obtained in 542. A total of 234 (43.1%) patients had pneumonia, of whom 210 underwent bacterial microbiologic studies. Of these patients, 174 (82.8%) had primary viral pneumonia and 36 (17.2%) had concomitant/secondary bacterial pneumonia. Bilateral pneumonia occurred in 48.3% of patients. Streptococcus pneumoniae was the most frequent pathogen among patients with bacterial pneumonia (26 of 36 patients). None of them had received pneumococcal vaccine. Compared with patients without pneumonia, those with pneumonia more frequently had shock during hospitalization (9.8% vs. 1%; p < 0.001), required intensive care unit admission (22.6% vs. 5.8%; p < 0.001), underwent mechanical ventilation (17.9% vs. 3.2%; p < 0.001), and had longer length of hospital stay (median, 7 d vs. 5 d; p < 0.001). In-hospital mortality was higher in patients with pneumonia than in the others (5.2% vs. 0%; p < 0.001). Absence of comorbid conditions (odds ratio [OR], 2.07; 95% confidence interval [CI], 1.32-3.24) was found to be an independent risk factor for pneumonia, whereas early (≤48 h) oseltamivir therapy (OR, 0.29; 95% CI, 0.19-0.46) was a protective factor. In conclusion, pneumonia is a frequent complication among adults hospitalized for pandemic (H1N1) 2009 and causes significant morbidity. Mortality in pandemic (H1N1) 2009 is low, but occurs mainly in patients with pneumonia. Early oseltamivir therapy is a protective factor for this complication. Abbreviations: BMI = body mass index, CAP = community-acquired pneumonia, CI = confidence interval, CURB-65 = confusion, urea, respiratory rate, blood pressure, and age ≥65 years, ICU = intensive care unit, OR = odds ratio, PSI = pneumonia severity index, ROC = receiver operating characteristic, RT-PCR = reverse-transcription polymerase chain reaction.
  Medicine 08/2011; 90(5):328-336.
• Article: Lung echinococcal cyst in a child – always a challenge: case report.

  Ilić D, Stojković A, Obradović S
  Medicine 01/2011; 45(2):36-39.
• Article: Case report of necrotizing sialometaplasia

  Bascones-Martínez A.Muñoz-Corcuera MCerero-LapiedraR.Bascones-Ilundain J.Esparza-Gómez G
  Medicine 01/2011;
• Article: Histoplasmosis in Australia: Report of 16 Cases and Literature Review

  Donald S. A. McLeod, Robin H. Mortimer, Donald A. Perry-Keene, Anthony Allworth, Marion L. Woods, Joanna Perry-Keene, William J. H. McBride, Christopher Coulter, Jennifer M. B. Robson
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  ABSTRACT: We describe 16 previously unreported patients with histoplasmosis from Queensland and northern New South Wales, Australia, and review all previous Australian reports, providing 63 cases in total to study (17 cases of acute pulmonary histoplasmosis, 2 cases of chronic pulmonary disease, and 44 cases of systemic disease, including 17 cases of single-organ infection and 27 instances of disseminated disease). All acute pulmonary disease was acquired in Australia, with 52% of systemic disease definitely autochthonous. Most cases of single-organ disease occurred in immunocompetent patients (76%), and were oropharyngeal (53%) in location. Forty-one percent of disseminated disease occurred in patients with human immunodeficiency virus (HIV). Patients with HIV had high rates of systemic symptoms, pancytopenia, fungemia, and hepatosplenomegaly. Oropharyngeal and adrenal involvement as well as systemic symptoms were prominent in immunocompetent patients with disseminated disease, with 6 of 7 cases of adrenal involvement leading to Addison disease. Most systemic disease was diagnosed by culture of Histoplasma capsulatum. Where serology was assessed in cases other than acute pulmonary disease, it was positive in only 32%. Prognosis for patients with single-organ disease was excellent. Disseminated disease was associated with recurrence in 30% and death in 37%. The results of this study confirm several previously known patterns of disease but also provide new insights into this rare but endemic condition in Australia. Abbreviation: HIV = human immunodeficiency virus.
  Medicine 12/2010; 90(1):61-68.
• Article: Clinical and Serologic Baseline and Follow-Up Features of Syphilis According to HIV Status in the Post-HAART Era

  David Farhi, Nadjet Benhaddou, Philippe Grange, Nada Zizi, Jean Deleuze, Jean-Pierre Morini, Philippe Gerhardt, Anne Krivine, Marie-Françoise Avril, Nicolas Dupin
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  ABSTRACT: There is a lack of large studies appraising the effect of the human immunodeficiency virus (HIV) on the course of syphilis since the advent of highly active antiretroviral therapy (HAART). We aimed to appraise the effect of HIV on clinical and serologic features of syphilis at baseline and during follow-up in the post-HAART era. We designed a retrospective cohort study of consecutive syphilis cases, diagnosed between 2000 and 2007, in an academic venereal disease center. Data were collected using standardized medical forms. Patients were treated according to the European guidelines. Serologic failure was defined as either a 4-fold rise in Venereal Disease Research Laboratory (VDRL) titers 30-400 days posttreatment or a lack of 4-fold drop in VDRL titers at 270-400 days posttreatment. Among 279 syphilis cases with informative baseline clinical and serologic data, HIV infection was significantly associated with men having sex with men, French origin, multiple partners, lesser usage of condom, history of sexually transmitted disease, early syphilis, anal primary chancre, and cutaneous eruption. Median baseline titer from the Treponema pallidum hemagglutination assay (TPHA) was higher in HIV-infected patients (p = 0.02). Among 144 informative syphilis cases, there was a nonsignificant trend for a lower rate of serologic response among HIV-positive patients (91.8% vs. 98.3%, p = 0.14). Serologic failure was significantly associated with a history of previous syphilis (p < 0.05). The median delay to serologic response was similar in HIV-positive (117 d) and in HIV-negative (123 d) patients (p = 0.44). We conclude that for patients under HAART treatment, the effect of HIV on serologic response to syphilis treatment is likely minimal or absent. Abbreviations: CSF = cerebrospinal fluid, FTA-abs = fluorescent treponemal antibody absorption test, HAART = highly active antiretroviral therapy, HIV = human immunodeficiency virus, HR = hazard ratio, MSM = men having sex with men, RPR = rapid plasma reagin, STD = sexually transmitted disease, TPHA = Treponema pallidum hemagglutination assay, VDRL = Venereal Disease Research Laboratory.
  Medicine 10/2009; 88(6):331-340.
• Article: Autoimmune and other blistering diseases

  Kathy Taghipour, Fenella Wojnarowska
  Medicine 06/2009; 37(6):291-297.
• Article: Artritis psoriásica.

  J.L. Fernández Sueiro, J.A. Pinto Tasende, A. Willisch Domínguez y J.C. Fernández López
  Medicine 01/2009; 10(30):2001-7.
• Article: Primary Sjögren syndrome in Spain: clinical and immunologic expression in 1010 patients.

  Manuel Ramos-Casals, Roser Solans, Jose Rosas, María Teresa Camps, Antonio Gil, Javier Del Pino-Montes, Jaime Calvo-Alen, Juan Jiménez-Alonso, Maria-Luisa Micó, Juan Beltrán, Rafael Belenguer, Lucio Pallarés
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  ABSTRACT: We conducted the current study to characterize the clinical presentation of primary Sjögren syndrome (SS) in a large cohort of Spanish patients and to determine whether epidemiologic, clinical, and analytical features modulate disease expression. Patients were from the GEMESS Study group, which was formed in 2005 and included 12 Spanish reference centers. By March 2007, the database included 1010 consecutive patients, recruited since 1994, both incident and prevalent cases. The cohort included 937 women and 73 men (ratio, 13:1), with a mean age of 53 years at diagnosis and 59 years at inclusion in the registry. Multivariate analysis showed that male patients had a lower frequency of thyroiditis, Raynaud phenomenon, and antinuclear antibodies. Young-onset patients had a low degree of sicca involvement (xerostomia and parotid enlargement) and a high frequency of immunologic markers (anti-Ro/SS-A and low C4 levels). Patients with disease duration of more than 10 years had a higher prevalence of xerophthalmia, parotid enlargement, lung involvement, and peripheral neuropathy in comparison with incident cases. The subset of patients with anti-Ro/La antibodies had the highest prevalence of most systemic, hematologic, and immunologic alterations (higher frequency of Raynaud phenomenon, altered parotid scintigraphy, positive salivary gland biopsy, peripheral neuropathy, thrombocytopenia, and rheumatoid factor). Hypocomplementemia was associated with a higher frequency of vasculitis and lymphoma, and cryoglobulins with a higher frequency of parotid enlargement, vasculitis, and leukopenia.Epidemiologic, clinical, and analytical features have a significant impact on the clinical presentation of primary SS, influencing the results of the main diagnostic tests, the prevalence and diversity of extraglandular involvement, and the frequency of the main immunologic markers. Primary SS should be considered as a systemic autoimmune disease that can express in many guises beyond sicca involvement.
  Medicine 08/2008; 87(4):210-9.
• Article: Histoplasmosis: a study of 158 cases in Venezuela, 2000-2005.

  Sofía Mata-Essayag, Maria Teresa Colella, Arantza Roselló, Claudia Hartung de Capriles, María Eugenia Landaeta, Celina Pérez de Salazar, Sylvia Magaldi, Carolina Olaizola, Maria I Calatroni, Liseloth Garrido
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  ABSTRACT: Histoplasmosis, a granulomatous disease caused by Histoplasma capsulatum, is endemic in Venezuela. We conducted the current study to appraise retrospectively the demographic data, clinical features, diagnostic methods, and treatment of patients with histoplasmosis from January 2000 to December 2005. We reviewed the medical records of outpatient cases with a diagnosis of histoplasmosis and considered clinical samples processed at our laboratory. We collected demographic, epidemiologic, and clinical data from each case as available, including results of any mycologic examinations performed. Treatment and outcome data were available for some patients. We assessed 158 cases of histoplasmosis: 103 (65.2%) patients came from the Caracas metropolitan area; 53 were associated with acquired immunodeficiency syndrome (AIDS), 14 with tuberculosis, and 8 with paracoccidioidomycosis. Six pediatric patients were malnourished. Epidemiologic data suggested histoplasmosis in most cases. Patients received treatment with itraconazole and/or amphotericin B. Our results may reflect changes in the epidemiology occurring in Venezuela, perhaps due to environmental changes and the presence of AIDS. Several mycologic exams are necessary to ensure a proper diagnosis. More reliable data and statistics on this infection are necessary to monitor outbreaks closely and to establish if there is an epidemic pattern.
  Medicine 08/2008; 87(4):193-202.
• Article: Antineutrophil cytoplasmic autoantibody-associated vasculitis in older patients.

  Min Chen, Feng Yu, Ying Zhang, Ming-Hui Zhao
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  ABSTRACT: Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) is increasingly recognized in older patients. The differences in disease presentation and outcome between older and younger patients remain controversial. We conducted the current study to analyze the characteristics of patients aged over 65 years with AAV and to compare the younger and older cohorts. We recruited 234 consecutive Chinese patients with AAV. We compared clinical and pathologic characteristics as well as outcomes between younger and older patients. Among the 234 patients with AAV, 99 were older than 65 years. Compared with the 135 younger patients, the older patients had a significantly higher proportion of positive myeloperoxidase-ANCA (94.9% vs. 80.0%, p < 0.01) and a higher proportion of microscopic polyangiitis (79.8% vs. 50.4%, chi = 11.8, p < 0.001), but had a lower proportion of Wegener granulomatosis (18.2% vs. 37.8%, p < 0.01) and renal-limited vasculitis (0% vs. 11.1%, p < 0.001).Older patients had more prevalent and severe pulmonary involvement than younger patients, including pulmonary infiltration, interstitial fibrosis, and mechanical ventilation dependence at presentation (47.5% vs. 31.9%, p < 0.05; 37.4% vs. 18.5%, p < 0.01; and 9.1% vs. 1.5%, p < 0.05, respectively). Older patients were less likely to respond to treatment (p < 0.01) and had worse survival than younger patients (p = 0.000). During follow-up, older patients had a higher risk of secondary pulmonary infection (p < 0.001), and those with pulmonary interstitial fibrosis were more likely to develop secondary pulmonary infections (p < 0.05). In conclusion, compared with younger patients, older patients with AAV had more severe and more prevalent pulmonary lesions, which might contribute to subsequent pulmonary infections after the initiation of immunosuppressive therapy. Age and pulmonary infection were independent predictors of death.
  Medicine 07/2008; 87(4):203-9.