RESUMEN
We describe the case of a young HIV-positive patient undergoing three-drug antiretroviral therapy that included a protease inhibitor for 9 months, who was admitted to the hospital with an acute myocardial infarction. A coronary angiogram revealed occlusion caused by a thrombus in the proximal third of the anterior descending artery. Complete recanalization was obtainedafter an angioplasty was performed. At the time of the infarction, only the triglyceride levels were found to be high. Metabolic alterations associated with the prolonged use of protease inhibitors have been described such as an increase in the triglyceride and the cholesterol serum levels, diabetes, resistence to insulin, lipodystrophy, and pancreatitis. The consequences of chronic hyperlipidemia are well known in the medical literature, especially premature coronary artery disease. No family history of coronary disease was identified in this patient. Whether the genesis of this localized thrombosis was due to a change in the metablism of the vascular endothelium caused by the protease inhibitors, or by related dyslipidemia, is still to be determined. In this case, the data suggest a strong link between coronary insufficiency and prolonged use of the protese inhibitor.
Asunto(s)
Humanos , Femenino , Adulto , Angioplastia , Antivirales/uso terapéutico , Angiografía Coronaria , Enfermedad Coronaria , VIH , Infarto del Miocardio/cirugía , Infarto del Miocardio/diagnóstico , Infarto del Miocardio/metabolismo , Inhibidores de Proteasas/efectos adversos , Inhibidores de Proteasas/metabolismo , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Hiperlipidemias/complicaciones , Hipertrigliceridemia/complicacionesRESUMEN
Se estudiaron en agar sabouraud dextrosado, muestras obtenidas del conducto auditivo externo de 80 perros y 22 gatos aparentemente sanos. El examen micológico directo y las características morfofisiológicas y bioquímicas, permitieron determinar la presencia de malassezia pachydermatis en el 61,3 porciento de las muestras provenientes de perros y en el 13,6 porciento de los gatos. La susceptibilidad de esta levadura se determinó en medios sólidos, por el método de dilución in vitro frente a soluciones de yodo, timerosal y violeta de genciana. Todas las cepas fueron inhibidas en las siguientes concentraciones: yodo 1,0 g/l; timerosal 0,0125 g/l y violeta de genciana a 0,0078 g/l, lo que representa su dilución comercial diluída 641 veces