Oral manifestations of HIV infection in adult patients from the province of Sancti Spiritus, Cuba.

BACKGROUND: Studies on the prevalence of HIV-related oral lesions (HIV-OL) have shown great variations among different countries. The aim of this study was to describe the prevalence of HIV-OL in adults infected with HIV in the province of Sancti Spiritus, Cuba, and to determine the factors associated with the presence of HIV-OL. METHODS: A cross-sectional observational study was performed between November 2006 and August 2007 at the Hospital General Universitario 'Camilo Cienfuegos', Sancti Spiritus. One hundred and fifty-four HIV-infected patients were included. Patients were examined and interviewed by a periodontal specialist. Diagnosis of HIV-OL was based on clinical criteria. Demographical, clinical and laboratory data were obtained. Independent association of each factor with HIV-OL was assessed by logistic regression modelling. RESULTS: The prevalence of HIV-OL was 40.9%. The commonest manifestation was oral hairy leucoplakia (n = 19; 12.3%); oral candidiasis (n = 17; 11%); herpes simplex virus infection (n = 11; 7.4%); and aphthous ulcer (n = 9; 5.8%). Principal factors associated with the presence of HIV-OL were CD4(+) lymphocytes <500 cells/mm(3) (OR: 2.06; 95% CI: 1.019-4.195) and smoking (OR: 2.03 CI: 1.037-3.982). CONCLUSION: This study described the prevalence of HIV-OL in 154 HIV-infected patients which represent about 80% of those known to be infected in the province of Sancti Spiritus. The prevalence of HIV-OL was lower than those reported from developing countries. Oral hairy leucoplakia and oral candidiasis were the most prevalent HIV-OL. Smoking and CD4(+) cells count <500 cells/mm(3) were the two factors independently associated with the presence of HIV-OL.

Methodologic requirements for assessing surgical procedures in current medical literature.

Even though, in theory, a new surgical technique should traverse all the stages established for drugs before being introduced into medical practice, it is suspected that many surgical procedures are utilized without having rigorously evaluated their efficacy and safety. With the aim of identifying the methodologic aspects currently employed for assessing new surgical procedures, a descriptive bibliographic study was carried out. Altogether, 75 journal articles published from 1996 to 1998 were reviewed. The papers must have come from studies carried out with the expressed objective of evaluating a surgical procedure and were selected through MEDLINE or directly from six prestigious medical journals (three specifically surgical and three general). Of the reviewed articles, 47% were retrospective studies, and the rest were prospective studies. More than 40% of the retrospective studies omitted some basic methodologic features, namely a description of the patients' source or a definition of the inclusion criteria. Among the 41 prospective articles, only 35 used a control group and 15 did not employ random allocation. Other basic issues, such as the sample size or inclusion of prognostic factors in the analysis, were present in fewer than 50% of the articles. It seems there is consensus about admitting that rigorous assessment of new surgical treatments should be an unavoidable condition before introducing such treatment into practice. The facts demonstrate that this principle is not being followed.