ABSTRACT
OBJECTIVE: HIV population is aging at an earlier age than those uninfected, requiring more non-HIV medications to treat noncommunicable diseases. In the context of chronic HIV infection, the next therapeutic change would be the polymedication control. This paper has the purpose of explore the attitudes of older people living with HIV toward deprescribing. METHODS: This was an observational, prospective and multicenter study conducted from March-April, 2018. People living with HIV (PLWH) on highly active antiretroviral therapy and older than 65 years were included. In addition to demographic and pharmacotherapeutic data, attitudes regarding deprescribing were collected through the "Revised Patients' Attitudes Towards Deprescribing Questionnaire". RESULTS: A total of 42 patients were included in this study. Regarding their attitudes in relation to deprescription, there were three statements with the most consensuses. The first ("I have a good understanding of the reasons I was prescribed each of my medicines") had 91.9% consensus. The second and third questions showed 89.2% consensus in both cases; "Overall, I am satisfied with my current medicines" and "I like to be involved in making decisions about my medicines with my doctors". CONCLUSIONS: This study is the first to explore the beliefs and attitudes of older PLWH in relation to deprescription process. There are positive attitudes regarding medication knowledge but there also is a percentage of patients who had a negative opinion regarding deprescription. We must study and go deeper in our knowledge of techniques that could help us to better understand their preferences, in order to establish effective and successful deprescription strategies.
Subject(s)
Deprescriptions , HIV Infections , Aged , Attitude , HIV Infections/drug therapy , Health Knowledge, Attitudes, Practice , Humans , Polypharmacy , Prospective StudiesABSTRACT
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Subject(s)
Aged , Female , Humans , Pelvic Bones , Chondrosarcoma , Bone NeoplasmsABSTRACT
BACKGROUND AND OBJECTIVE: Erythema migrans (EM) is the earliest and most common manifestation of the infection caused by B. burgdorferi (Lyme borreliosis). The objective of the present work was to report the clinicoepidemiological features in a series of patients. PATIENTS AND METHODS: Retrospective collection of clinicoepidemiological features of the first fifty patients diagnosed of EM at La Rioja Hospital (March 1989-September 1998). RESULTS: In our series, no differences were observed regarding sex or living in a rural or urban area. Mean age was 41 years (range 9 to 78). In 70% of patients the antecedent of a tick bite was obtained and the incubation period was 6.48 days (1 to 15 days). The mean size of the lesions was 14.3 cm (5 to 40) and in 16% of patients satellite cutaneous lesions were observed. The areas where EM appeared were lower limbs and the perineal region (60%), chest (24%), head and neck (10%) and upper limbs (6%). Forty-eight percent of patients reported extra-cutaneous manifestations. All cases occurred during the spring, summer and autumn months, with a peak in June. The most common referred antecedent was walking in forest areas. All patients responded to antibiotic therapy. CONCLUSIONS: EM is common in the studied environment and presents with a marked polymorphism.
Subject(s)
Lyme Disease/diagnosis , Lyme Disease/epidemiology , Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Retrospective StudiesABSTRACT
BACKGROUND: Bartonella henselae infections are closely related to a number of clinical conditions of growing interest in our environment. As cats are the reservoir, and their bites and scratches are the main transmission mechanism, we attempted to study the seroepidemiology of the infection caused by this microorganism in a risk group of patients (cat owners) and a control group (blood donors). PATIENTS AND METHODS: October 1977. Measurement of antibody titres to B. henselae at different dilutions (breakpoint > or = 1:64) by indirect immunofluorescence (IFI) in 83 cat owners and 85 blood donors. Also, an epidemiologic investigation was carried out (age, sex, alcohol, intake, common cat exposure, cat bite or cat scratch, number and age of cats, bite or presence of fleas, use of repellents, clinical picture consistent with cat scratch disease [CSD]). RESULTS: Twenty-four cat owners (28.9%) and five blood donors (5.9%) had titres > or = 1:64 (OR: 6.51; 95% CI: 2.32 to 22.9). Also, the logistic regression analysis showed an association with daily alcohol intake and the previous antecedent of lymph node enlargement of unknown origin among cat owners. CONCLUSIONS: A high prevalence of antibodies to B. henselae was demonstrate among cat owners.
