Estadísticas

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      "titulo" => "Fungemias por Candida no albicans en pacientes con infección por el VIH"
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      "titulo" => "Bacilos gramnegativos no fermentadores (BGNNF) aislados en un laboratorio hospitalario"
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    "titulo" => "Criptococosis no asociada al sida: estudio clínico de siete pacientes"
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        "titulo" => "Cryptococcosis not associated with AIDS. Clinical study of seven patients"
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        "resumen" => "<span class="elsevierStyleBold">Fundamento&#58;</span> Estudio de las caracter&#237;sticas cl&#237;nicas&#44; los m&#233;todos diagn&#243;sticos&#44; la respuesta al tratamiento y la evoluci&#243;n de la criptococosis no asociada al sida&#46; <br/> <span class="elsevierStyleBold">M&#233;todos&#58;</span> Se describen 7 casos estudiados en el Hospital Ram&#243;n y Cajal de Madrid durante un per&#237;odo de 19 a&#241;os &#40;1980-1998&#41;&#46; El diagn&#243;stico se estableci&#243; por cultivo de l&#237;quido cefalorraqu&#237;deo&#44; sangre u otras muestras cl&#237;nicas&#46; <br/> <span class="elsevierStyleBold">Resultados&#58;</span> Cuatro pacientes eran varones y la edad media fue de 45&#44;1 a&#241;os &#40;l&#237;mites 23-69 a&#241;os&#41;&#46; Todos menos uno presentaban alguna enfermedad predisponente y tres recib&#237;an corticoides y&#47;o inmunosupresores&#46; Seis presentaron meningitis y uno neumon&#237;a&#46; La meningitis curs&#243; de forma subaguda&#44; con pleocitosis&#44; hipoglucorraquia e hiperproteinorraquia en la mayor&#237;a de los enfermos&#46; La tinci&#243;n con tinta china&#44; el cultivo y el ant&#237;geno criptoc&#243;cico del l&#237;quido cefalorraqu&#237;deo fueron positivos en todos los casos de meningitis evaluados&#46; Todos los pacientes fueron tratados inicialmente con anfotericina y fluorocitosina&#46; Esta pauta fue sustituida en 2 casos por formulaciones lip&#237;dicas de anfotericina&#44; a causa de los efectos adversos&#44; y por fluconazol de forma electiva en otro&#46; La evoluci&#243;n fue favorable en todos los enfermos&#46; Una paciente present&#243; una recidiva men&#237;ngea y cut&#225;nea&#46; Tres enfermos fallecieron&#44; ninguno durante el episodio agudo ni como consecuencia de la infecci&#243;n&#46; <br/> <span class="elsevierStyleBold">Conclusiones&#58;</span> La criptococosis no asociada al sida es una entidad excepcional en nuestro medio&#46; Suele cursar con meningitis subaguda hipoglucorr&#225;quica y las t&#233;cnicas diagn&#243;sticas convencionales &#40;tinci&#243;n con tinta china&#44; ant&#237;geno criptoc&#243;cico y cultivo&#41; ofrecen una adecuada rentabilidad&#46; La respuesta al tratamiento con anfotericina y fluorocitosina es habitualmente favorable&#44; aunque existen alternativas terap&#233;uticas adecuadas para casos seleccionados&#46;"
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        "resumen" => "<span class="elsevierStyleBold">Background&#58;</span> The aim of the present was to study the clinical characteristics&#44; the diagnostic methods&#44; response to treatment and the evolution of cryptococcosis not associated with AIDS&#46; <br/> <span class="elsevierStyleBold">Methods&#58;</span> Seven cases studied in the Hospital Ram&#243;n y Cajal of Madrid&#44; Spain over a 19-year period &#40;1980-1998&#41;&#46; Diagnosis was determined by LCR culture&#44; blood or other clinical samples&#46; <br/> <span class="elsevierStyleBold">Results&#58;</span> Four patients were males with a mean age of 45&#46;1 years &#40;range&#58; 23-69 years&#41;&#46; All except one case presented a predisposing disease and three received corticoids and&#47;or immunosuppressive drugs&#46; Six patients presented meningitis and one pneumonia&#46; The meningitis showed a subacute course with pleocytosis&#44; hypoglycorrhachia and hyperproteinorrhachia in most of the patients&#46; Chinese ink staining&#44; culture and the cryptococcic antigen of LCR were positive in all the cases of meningitis evaluated&#46; All the patients were initially treated with amphotericin and fluorocytosin&#46; This schedule was substituted in two cases by amphotericin lipid formulas because of adverse effects and by fluconazol as an elective choice in one case&#46; The evaluation was favorable in all the patients&#46; One patient presented meningeal and cutaneous recurrence&#46; Three patients died&#44; although none did so during the acute episode or as a consequence of the infection&#46; <br/> <span class="elsevierStyleBold">Conclusions&#58;</span> Cryptococcosis not associated with AIDS is rare in Sapin&#46; It usually evolves with subacute hypoglucorrhachic meningitis and the conventional diagnostic techniques &#40;Chinese ink staining&#44; cryptococcic antigen and culture&#41; provide adequate profitability&#46; Response to treatment with amphotericin and fluorocytosis is usually favorable&#44; although there are therapeutic alternatives which are adequate for selected cases&#46;"
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