ABSTRACT
Although treatment of visceral leishmaniasis with pentavalent antimony is usually successful, some patients require second-line drug therapy, most commonly with amphotericin B. To identify the clinical characteristics that predict an inadequate response to pentavalent antimony, a case-control study was undertaken in Teresina, Piaui, Brazil. Over a two-year period, there were 19 cases of VL in which the staff physicians of a hospital prescribed second-line therapy with amphotericin B after determining that treatment with pentavalent antimony had failed. The control group consisted of 97 patients that were successfully treated with pentavalent antimony. A chart review using univariate and multivariate analysis was performed. The cure rate was 90 percent with amphotericin B. The odds ratio for the prescription of amphotericin B was 10.2 for children less than one year old, compared with individuals aged over 10 years. Patients who presented coinfection had an OR of 7.1 while those on antibiotics had an OR of 2.8. These data support either undertaking a longer course of therapy with pentavalent antimony for children or using amphotericin B as a first-line agent for children and individuals with coinfections. It also suggests that chemoprophylaxis directed toward bacterial coinfection in small children with VL may be indicated
Subject(s)
Adolescent , Adult , Child , Child, Preschool , Female , Humans , Infant , Male , Amphotericin B/therapeutic use , Antimony/therapeutic use , Antiprotozoal Agents/therapeutic use , Leishmaniasis, Visceral/drug therapy , Antimony/adverse effects , Case-Control Studies , Treatment FailureABSTRACT
Los autores estudian los cambios observados en las internacions de pacientes con UMI dutante el período 1995-1998 en el Hospital Carrasco, con especial referncia a egresos, tiempo de estadía, costos de internación y reinternaciones.Exponen protocolo de internacxión para estos pacientes, haciéndose referencia también a los problemas sociales que estas patologías determinan
Subject(s)
Humans , Clinical Protocols , Cost of Illness , Hospital Costs/statistics & numerical data , Leg Ulcer/epidemiology , Leg Ulcer/psychology , Length of Stay/statistics & numerical dataABSTRACT
In order to detect seasonal trends in the age structure of adult mosquitoes from Buenos Aires province, Argentina, female populations were sampled with CDC traps during 1989-1991 in Punta Lara and La Plata. The mosquitoes were dissected and age-grouped according to ovarian tracheation and ovariolar stages. All Runchomyia paranensis females were parous, suggesting that the species could be autogenous. Aedes albifasciatus showed porous peaks following population peaks, with shorter delays in Spring-Summer and longer in Fall-Winter. Ae. crinifer and Culex dolosus showed wide fluctuations in age structure due to adult emergences during all months. Psorophora ferox showed high population replacement rates. Mansonia indubitans and Ma. titillans have few generations per year during their activity period. This is the first report on age-grading of adults of field mosquito populations form Argentina.
Subject(s)
Animals , Culicidae/growth & development , Maternal AgeABSTRACT
Se presenta el caso de una mujer de 23 años de edad,adicta parental y heterosexual (ejercía la prostitución), que desarrolló lesiones de Kaposi en mucosa oral e infección pulmonar a P. carinii. Se discute la infrecuencia de casos y los factores que pueden predisponer a que la mujer HIV positiva pueda desarrrollar un sarcoma de Kaposi