ABSTRACT
OBJECTIVE: Determine the prevalence of metabolic abnormalities (MA) and estimate the 10-year risk for cardiovascular disease (CVD) among Latin American HIV-infected patients receiving highly active anti-retroviral therapy (HAART). METHODS: A cohort study to evaluate MA and treatment practices to reduce CVD has been conducted in seven Latin American countries. Adult HIV-infected patients with at least one month of HAART were enrolled. Baseline data are presented in this analysis. RESULTS: A total of 4,010 patients were enrolled. Mean age (SD) was 41.9 (10) years; median duration of HAART was 35 (IQR: 10-51) months, 44 percent received protease inhibitors. The prevalence of dyslipidemia and metabolic syndrome was 80.2 percent and 20.2 percent, respectively. The overall 10-year risk of CVD, as measured by the Framingham risk score (FRF), was 10.4 (24.7). Longer exposure to HAART was documented in patients with dyslipidemia, metabolic syndrome and type 2 diabetes mellitus. The FRF score increased with duration of HAART. Male patients had more dyslipidemia, high blood pressure, smoking habit and higher 10-year CVD than females. CONCLUSIONS: Traditional risk factors for CVD are prevalent in this setting leading to intermediate 10-year risk of CVD. Modification of these risk factors through education and intervention programs are needed to reduce CVD.
Subject(s)
Adult , Female , Humans , Male , Middle Aged , Anti-HIV Agents/adverse effects , Antiretroviral Therapy, Highly Active/adverse effects , Cardiovascular Diseases/chemically induced , HIV Infections/drug therapy , Metabolic Diseases/chemically induced , Cohort Studies , /chemically induced , Dyslipidemias/chemically induced , HIV Infections/blood , HIV Infections/complications , Latin America , Metabolic Syndrome/chemically induced , Risk FactorsABSTRACT
Se analizaron restrospectivamente 53 casos de tétanos del adulto admitidos en la sala de terapia intensiva entre los años 1986 y 1987. Cerca de la mitad de los ingresos (47 por ciento) tuvieron el antecedente de la aplicación de inyectables por vía intramuscular. La mortalidad de ese grupo fue del 84 por ciento vs. el 33 por ciento del grupo asociado a heridas. El período de incubación en 22 de 25 pacientes fue menor de 5 días, con generalización de los síntomas en las 24 horas siguientes a la aparición del trismus. Esta evolución se observó en 5 de 21 pacientes con antecedentes de heridas. Se advierte sobre el aumento de la enfermedad asociada a inyecciones IM y la identificación de un grupo de alto riesgo en quienes se recomienda asegurar la correcta inmunización previo a la terapeútica por esa vía de administración