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J Ortiz Vázquez
Revista Clínica Española 12/1995; 195(11):792-800. · 2.01 Impact Factor
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J Ortiz Vázquez
Revista Clínica Española 04/1994; 194(3):176-82. · 2.01 Impact Factor
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ABSTRACT: Comparison was made of the aetiology and methods of diagnosis in two series of patients meeting the classic criteria of pyrexia of unknown origin during 1968-1981 and during 1982-1989 seen in the Department of Internal Medicine at La Paz University Hospital, Madrid, Spain. There was a statistically significant decrease in the percentage of infections and an increase in neoplasms and connective tissue disorders in the second series. The percentage of patients diagnosed by laparatomy was similar in both series but the diagnosis yield at laparotomy was greater in the second period. Pyrexia of unknown origin continues to be a condition which can defy clinical expertise in in spite of advances in diagnostic techniques.
Postgraduate Medical Journal 12/1992; 68(805):884-7. · 1.94 Impact Factor
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ABSTRACT: To evaluate the efficacy and pharmacological safety of 2 therapeutic trials with fluconazole in candida esophagitis in AIDS patients.
A total of 75 episodes of candida esophagitis in 70 AIDS patients were included in an open prospective study. In group I 36 patients were included who received 200 mg of fluconazole orally the first day followed by 100 mg daily for 4 weeks. In group II (34 patients) the length of treatment was reduced to 10 days with the same daily doses. Therapeutic response was evaluated by esophagoscopy, biopsy and fungal culture.
The protocol was completed at 68 episodes with a cure being obtained in all but 2 patients in group II. No significant differences in clinical response were found between the 2 groups. The incidence of oropharyngeal colonization at the end of treatment was greater in patients from group I than from group II (43% vs 11%). Fluconazole was well tolerated in all the patients. A slight alteration of the hepatic enzymes was observed in 29 cases (40%) with a lower incidence in the shorter time group (p less than 0.001), however, treatment was discontinued only in 1 patient because of severe asymptomatic hepatic dysfunction to which a relation with the drug is unclear.
Fluconazole in an efficient and safe agent in the treatment of candida esophagitis in AIDS patients. A 10 day treatment is a useful as longer treatment and has a lower risk of adverse effects.
Medicina Clínica 05/1992; 98(16):612-7. · 1.38 Impact Factor
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ABSTRACT: In order to evaluate the efficacy of 200 mg single weekly dose of fluconazole in the secondary prophylaxis of esophageal candidiasis in AIDS, 18 patients who had an endoscopic confirmation of cure after an esophageal candidiasis, were studied. Mean follow up period was 12.5 months (limit: 1.5-18) and 11 patients completed prophylaxis for 11.2 months (limit: 2-18). Fluconazole was interrupted in the 7 remaining patients due to different reasons after 10 months and they were followed for 3.2 more months (limit: 1-5). Ten patients relapsed with a total of 17 episodes (7 oropharyngeal and 10 esophageal). Only 4 of the 18 patients (22%) relapsed while on correct prophylactic treatment. On the other hand, 6 out of 7 patients (86%) relapsed in the absence of fluconazole (p less than 0.001). The relapse incidence rate in both groups was 0.09 and 1.46/100 patients/day respectively (p less than 0.001) and its appearance was much earlier (1.3 versus 9.5 months) in patients not receiving prophylaxis. Relapses did not correlate with CD4 cell level, HIV-Ag level, opportunistic infections, use of other drugs or mortality. Fluconazole was interrupted in 3 patients because of alternations in liver enzymes although its relationship with the drug was not confirmed. These results indicate that the administration of Fluconazole 200 mg/week in a single dose is very efficiency in secondary prophylaxis of esophageal candidiasis in AIDS patients.
Revista Clínica Española 03/1992; 190(3):115-9. · 2.01 Impact Factor
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ABSTRACT: The efficacy and safety of fluconazole in the treatment of oesophageal candidiasis in patients with the acquired immunodeficiency syndrome (AIDS) was assessed in 36 patients. Fluconazole, 200 mg orally, was given on the first day, followed by 100 mg daily for 4 weeks. Clinical and mycological evaluation was performed in 31 patients at the end of treatment and 24 were also assessed after 8 weeks of starting treatment. In 1 patient fluconazole was discontinued, 5 patients were lost to follow-up and 6 patients died during the study. Clinical and mycological cure was achieved in all patients; in 31 of 36 patients the clinical picture resolved within a week. The cure was confirmed in 27 patients by oesophagoscopy. Two patients relapsed 1 month after stopping fluconazole but the reinstitution of therapy achieved cure. Asymptomatic fungal oropharynx colonization was evident in about 40% of patients during treatment and follow-up period. Fluconazole was well tolerated by all patients but mild to moderate increase of liver enzymes values occurred in 16. Treatment had to be discontinued in 1 patient with hepatic tuberculosis because of severe liver function abnormalities, but their relation with the drug was uncertain. Fluconazole is an effective and safe treatment of oesophageal candidiasis in AIDS patients.
Postgraduate Medical Journal 07/1991; 67(788):548-52. · 1.94 Impact Factor
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ABSTRACT: We determined blood pH, plasma hypoxanthine (Hx) and intraerythrocyte ATP (iATP) concentrations in umbilical cord blood from 20 normal newborn infants (10 delivered by the vaginal route and 10 by caesarean section) and in 18 newborns with clinical signs of perinatal asphyxia (9 with meconium stained amniotic fluid and 9 with fetal bradycardia). Blood pH was significantly lower in infants with clinical signs of perinatal asphyxia (p less than 0.01). Four newborns with meconium or bradycardia had pH values within normal control levels. Hx concentrations were lower in infants delivered by caesarean section with respect to normal infants born by the vaginal route (p less than 0.05). Newborns with meconium or fetal bradycardia showed Hx concentrations higher than normal newborns (p less than 0.01), but 2 infants with signs of perinatal hypoxia had Hx levels within the normal newborn range. All babies with meconium or bradycardia had an iATP concentration lower than control infants (p less than 0.01). These results indicate that: the pH and Hx determinations in the newborn may underestimate hypoxia and, that measurement of iATP may be useful parameters to asses perinatal hypoxia.
Anales espanoles de pediatria 08/1989; 31(1):5-9.
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ABSTRACT: Acquired hemophilia (idiopathic or secondary) is an uncommon clinical condition. A 70-year-old male had a severe hemorrhagic disorder, and an IgG inhibitor of the factor VIII:C was detected in plasma. During the acute phase he was treated with packed red blood cells, frozen fresh plasma and polyvalent immunoglobulins. The hemorrhagic features subsided but the circulating anticoagulant persisted. The administration of an activated prothrombin complex permitted to make the diagnosis of the underlying disease, a highly malignant T type lymphoma. During the treatment with corticosteroids and polychemotherapy the inhibitor activity disappeared.
Medicina Clínica 07/1989; 93(1):23-5. · 1.38 Impact Factor
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ABSTRACT: The transfer of purines through the hematoencephalic barrier is poorly understood. Allopurinol inhibits the enzyme xanthine oxidase and increases xanthine and hypoxanthine plasma levels, but it should not increase the cerebrospinal fluid (CSF) levels of these purines owing to the absence of xanthine oxidase in the central nervous system (CNS). In the present study we evaluated the plasma and CSF concentrations of uric acid, hypoxanthine, xanthine and inosine in the baseline state and after 7 days of allopurinol administration (5-10 mg/kg/24 h) in 4 patients with hypoxanthine phosphoribosyltransferase (HPRT) deficiency. The CSF uric acid level was positively correlated with its plasma level (r = 0.93, p less than 0.01). The CSF hypoxanthine and xanthine concentrations were, as a mean, 5 and 2 times higher, respectively, in patients with HPRT deficiency than in 4 control individuals. As hypoxanthine basically comes from adenine nucleotides, while xanthine comes from guanine nucleotides, this finding suggests that in the CNS of patients with HPRT deficiency there is a higher degradation level of adenine nucleotides than of guanine nucleotides. Allopurinol increased plasma concentration of hypoxanthine, xanthine and inosine 4, 10 and 3 times, respectively, in relation to baseline values. In CSF, the mean increase of hypoxanthine and xanthine concentration was 17.5 mumol and 7.7 mumol, respectively, whereas inosine level was unchanged. These results suggest that in HPRT deficiency hypoxanthine and xanthine may be transferred to the brain.
Medicina Clínica 03/1989; 92(5):167-70. · 1.38 Impact Factor
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Revista Clínica Española 02/1988; 182(1):30-3. · 2.01 Impact Factor
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Revista Clínica Española 12/1986; 179(7):359-61. · 2.01 Impact Factor
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Medicina Clínica 11/1985; 85(10):400-3. · 1.38 Impact Factor
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Revista española de las enfermedades del aparato digestivo 02/1985; 67(1):15-24.
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Advances in experimental medicine and biology 01/1984; 165 Pt A:193-5. · 1.09 Impact Factor
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Medicina Clínica 12/1983; 81(14):615-7. · 1.38 Impact Factor
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Medicina Clínica 07/1983; 81(2):47-50. · 1.38 Impact Factor
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Revista española de las enfermedades del aparato digestivo 03/1983; 63(2):172-9.
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ABSTRACT: Pyrazinamide and probenecid tests were used to study the renal mechanisms for urate excretion in 10 normal subjects in the state of low serum uric acid levels (below 3.5 mg/dl), normal serum urate concentrations (between 3.6 and 6.4 mg/dl) and high serum uric acid levels (above 6.5 mg/dl). Presecretory reabsorption of urate was above 99% in all three conditions of uricemia, indicating that filtered urate is nearly completely reabsorbed in the proximal tubule regardless of serum uric acid concentrations. Urate secretion was significantly higher and postsecretory reabsorption was significantly lower when serum uric acid was raised than when serum urate levels were normal or low. The findings indicate that both urate secretion and postsecretory reabsorption play a role in urate homeostasis in states of hyperuricemia.
Nephron 02/1983; 35(3):183-6. · 13.26 Impact Factor
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Medicina Clínica 11/1982; 79(6):268-72. · 1.38 Impact Factor
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Medicina Clínica 06/1982; 78(10):421-6. · 1.38 Impact Factor
