Miguel González

Bacteremic Pneumonia Due to Staphylococcus aureus: A Comparison of Disease Caused by Methicillin-Resistant and Methicillin-Susceptible Organisms

We performed a prospective study of all patients with bacteremic pneumonia due to Staphylococcus aureus over a period of 6 years during an outbreak of methicillin-resistant S. aureus (MRSA). Patients with bacteremic pneumonia due to MRSA (32 cases) or methicillin-susceptible S. aureus (MSSA; 54 cases) were compared. The patients with MRSA pneumonia were older and were more likely than those with MSSA pneumonia to have predisposing factors for acquisition of the infection. There were no differences in clinical findings, radiological pattern, or complications in clinical evolution among patients with MRSA and MSSA pneumonia. Mortality was significantly higher among MSSA-infected patients treated with vancomycin than among those treated with cloxacillin (47% vs. none; P<.01). Multivariate analysis (stepwise logistic regression method) showed a relationship between mortality and the following variables: septic shock (odds ratio [OR], 61), vancomycin treatment (OR, 14), and respiratory distress (OR, 8).

The importance of educational and psychological factors in Parkinson's disease quality of life

Objective:  To define the factors correlated with quality of life (QoL) in patients with idiopathic Parkinsons disease (PD).

New two‐pole approximation for the plasma dispersion function Z

A new two‐pole approximation for the plasma dispersion function Z (s) is obtained by a modified Pade (1/2) approximant. It gives a better agreement than the known two‐pole approximation. It also has the advantage that the same poles are used for Z (s) and its derivative Z′ (s).

On the limit behavior of a supercritical bisexual Galton–Watson branching process with immigration of mating units

In this paper a bisexual Galton–Watson branching process allowing the immigration of mating units is introduced and its limit behaviour is investigated. For the supercritical case, i.e., asymptotic growth rate greater than one, necessary and sufficient conditions for the almost sure and L 1 convergence of the suitably normed underlying sequences are given. *Research supported by the Consejerı´a de Educación y Juventud de la Junta de Extremadura and the Fondo Social Europeo, grant IPR98A023.

Bayesian inference for bisexual galton-watson processes

In this work, an approach to the Bayesian estimation in a bisexual Galton-Watson process is considered. First we study an important parametric case assuming offspring distribution belonging to the bivariate series power family of distributions and then, we continue to investigate the nonparametric case. In both situations, Bayes estimators under weighted squared error loss function, for means, variances and covariance of the off spring distribution are obtained. For the superadditive case, the Bayes estimation of the asymptotic growth rate is also considered. Illustrative examples are given.

What contributes to driving ability in Parkinson's disease

Purpose. To determine the most significant clinical predictors that influence driving ability in Parkinson disease (PD). Methods. National-multi-centre, cross-sectional study covering PD outpatients. Clinical assessment was based on the following questionnaires: cognition (SCOPA-Cog); motor impairment and disabilities (SCOPA motor); depression/anxiety; sleep (SCOPA-Sleep); psychosis and severity/global impairment (HY and CISI-PD). Driving status data was obtained using a standardized questionnaire. Comparisons between drivers and ex-drivers were calculated using χ2 and Student t-tests as appropriate. Multi-variate logistic regression analysis was performed to identify independent driving ability clinical predictors. Results. Compared with the drivers, the ex-drivers were older (p = 0.00005), had longer disease duration (p = 0.03), had more overall cognitive dysfunction (p = 0.004) and had greater motor impairment, as measured by the CISI (p = 0.02), HY stage (p = 0.034) and by the SCOPA-motor scale (p = 0.002) and difficulty in activities of daily life (p = 0.002). In the regression model analysis, aging and ADL impairment were the principal clinical predictors that differentiated drivers from ex-drivers. Conclusions. Although overall driving impairment in PD is associated with advancing disease severity, driving ability seems to be more strongly influenced by age and ADL impairment. Multi-disciplinary teams are required to assess driving ability in patients with PD and develop rehabilitation measures for safer driving.

Limit behaviour for a subcritical bisexual Galton{Watson branching process with immigration (

A bisexual Galton-Watson branching process allowing immigration of females and males is considered and for the subcritical case, i.e. growth rate less than one, the limit behaviour of related sequences is investigated.

Staphylococcus aureus bacteremic pneumonia: differences between community and nosocomial acquisition

OBJECTIVE The aim of the study was to ascertain the clinical and epidemiologic characteristics of patients with nosocomial or community-acquired Staphylococcus aureus bacteremic pneumonia. METHODS A prospective study of 134 cases diagnosed between January 1990 and December 1995 was performed. RESULTS Fifty cases involved primary bacteremic pneumonias, of which 80% were nosocomial (the majority, 72%, in intensive care unit patients, of whom 57% were post-surgery). Of the 84 cases of secondary pneumonia, 36 were non-intravenous drug users (78% nosocomial, of whom 43% were in the intensive care unit), and 48 cases were intravenous drug users (98% community-acquired). CONCLUSIONS Nosocomial S. aureus bacteremic pneumonia was especially frequent in intensive care unit patients (68.1%), and community-acquired pneumonia in intravenous drug users (72.3%). In non-intravenous drug users, clinical outcome and mortality were similar for nosocomial and community-acquired pneumonia.

Impact of placebo assignment in clinical trials of tic disorders.

Understanding the impact of placebo treatment is pivotal to the correct interpretation of clinical trials. The aim of present study was to examine the placebo effect in tic disorders.

Chemokines and relapses in childhood acute lymphoblastic leukemia: A role in migration and in resistance to antileukemic drugs

We studied whether chemokines may have a role in relapses in childhood acute lymphoblastic leukemia (ALL). We compared the levels of chemokine receptors in marrow samples from 82 children with ALL at diagnosis versus 15 at relapses, and quantified the levels of chemokines in central system fluid (CSF) samples. The functional role of specific chemokines was studied in vitro and in vivo. The expression of some chemokine receptors was upregulated upon leukemic relapse, both in B- and in T-ALL, and in cases of medullary and extramedullary involvement. CXCL10 induced chemotaxis in leukemic cell lines and in primary leukemic cells, depending upon the levels of CXCR3 expression. CXCL10 specifically diminished chemotherapy-induced apoptosis on ALL cells expressing CXCR3, partially inhibiting caspase activation and maintaining the levels of the antiapoptotic protein Bcl-2. Finally, immunodeficient mice engrafted with CXCR3-expressing human leukemic cells showed decreased infiltration of marrow, spleen, and CNS after receiving a CXCR3-antagonist molecule. CXCR3 signaling in ALL may have a dual function: chemotactic for the localisation of leukemic blasts in specific niches, and it may also confer resistance to chemotherapy, enhancing the chances for relapses.