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1.
Curr HIV Res ; 10(6): 513-20, 2012 Sep.
Article in English | MEDLINE | ID: mdl-22716109

ABSTRACT

OBJECTIVE: To evaluate long-term outcomes in patients maintaining a nevirapine (NVP)-based regimen. METHODS: Retrospective, multicenter, cohort study including patients currently receiving an NVP regimen that had been started at least 5 years previously. Demographic, clinical, and analytical variables were recorded. RESULTS: Median follow-up was 8.9 (5.7-11.3) years. Baseline characteristics: 74% men, 47 years old, 36% drug users, 40% AIDS, 40% HCV+, 51.4% detectable HIV-1 viral load, CD4 count 395 (4-1,421)/µL, 19% CD4 < 200/µL, 27% ALT grade 1-2, 36% AST grade 1-2. Thirty percent ART-naive, 83%received NVP associated with 2 nucleoside analogues during the study period, and 17% a protease inhibitor. A significant improvement was observed in general health status markers, including hemoglobin, platelets, and albumin, regardless of HCV coinfection. CD4 cell gain was +218 and +322/µL after 6 and 9 years, respectively (+321 and +391 in naive patients). Triglycerides significantly decreased in pretreated patients, whereas the percentage of patients with HDLc < 1.03 mmol/L and LDL-c > 3.37 mmol/L significantly decreased in a subsample with available values. A significant decrease in transaminases, alkaline phosphatase, and Fib4 score was observed, mainly in HCV+ and ARV-naive patients. CONCLUSIONS: In patients who tolerate NVP therapy, (even those with HCV coinfection), long term benefits may be significant in terms of a progressive improvement in general health status markers and CD4 response, a favorable lipid profile, and good liver tolerability.


Subject(s)
Acquired Immunodeficiency Syndrome/drug therapy , Anti-HIV Agents/administration & dosage , Hepatitis C/drug therapy , Liver/drug effects , Nevirapine/administration & dosage , Substance-Related Disorders/epidemiology , Acquired Immunodeficiency Syndrome/blood , Acquired Immunodeficiency Syndrome/epidemiology , CD4 Lymphocyte Count , Cholesterol/blood , Cohort Studies , Coinfection , Drug Therapy, Combination , Female , Follow-Up Studies , Hepatitis C/blood , Hepatitis C/epidemiology , Humans , Male , Middle Aged , Retrospective Studies , Spain/epidemiology , Time Factors , Treatment Outcome , Triglycerides/blood , Viral Load
2.
J Cardiovasc Surg (Torino) ; 41(2): 317-9, 2000 Apr.
Article in English | MEDLINE | ID: mdl-10901544

ABSTRACT

A 35 year old woman, cocaine addict, suffered Candida albicans aortic valve endocarditis complicated with embolisation of infected vegetations in the distal abdominal aorta. She underwent successful staged aortic valve replacement followed by transaortic and transfemoral thrombectomy. One month later an arteriogram disclosed partial occlusion of the left iliac artery, bilateral aneurysmal degeneration of both iliac arteries and right iliac artery-right iliac vein fistula. She was operated again, performing re-laparotomy and re-exploration. A composite bifurcated cryopreserved homograft was implanted end-to-side between the infrarenal abdominal aorta, right external iliac artery and left common femoral artery. The right iliac artery-iliac vein fistula was obliterated with suture. The patient had an uneventful recovery but a relapsing arterio-venous fistula was diagnosed by arteriography. Three months later she underwent percutaneous transluminal closure of the reopened fistula. At present, 17 months after the implantation of the homograft, the patient is symptom-free, on antifungal agents and with arteriographic and clinical evidence of a well-functioning arterial homograft.


Subject(s)
Aorta, Abdominal/transplantation , Blood Vessel Prosthesis Implantation , Candidiasis/surgery , Endocarditis, Bacterial/surgery , Femoral Artery/transplantation , Iliac Artery/transplantation , Adult , Angiography , Aorta, Abdominal/diagnostic imaging , Aortic Valve Insufficiency/diagnostic imaging , Aortic Valve Insufficiency/surgery , Cryopreservation , Female , Femoral Artery/diagnostic imaging , Heart Valve Prosthesis Implantation , Humans , Iliac Artery/diagnostic imaging , Reoperation , Thrombosis/diagnostic imaging , Thrombosis/surgery , Transplantation, Homologous
3.
Tex Heart Inst J ; 27(4): 356-60, 2000.
Article in English | MEDLINE | ID: mdl-11198308

ABSTRACT

From January 1991 through December 1999, 5 consecutive patients who were infected with human immunodeficiency virus presented in need of cardiac surgery. All were men; the median age was 44 years. Two of them presented with mitral and aortic infectious valve endocarditis, 1 with tricuspid endocarditis, 1 with prosthetic valve endocarditis, and 1 with pericarditis and pericardial tamponade. Under cardiopulmonary bypass, the 4 patients with endocarditis underwent these procedures: mitral and aortic valve replacement (2), tricuspid valve replacement (1), and aortic valve replacement (reoperation) and concomitant repair of a mycotic ascending aortic aneurysm (1). In the patient who had pericardial effusion, subxifoid pericardiostomy and drainage were performed, and a pericardial window was created. There was no intraoperative mortality. The patient with pericardial effusion died 8 days after surgery; he was in septic shock and had multiple organ failure. Two deaths occurred at 2 and 63 months, due to hemoptysis and sudden death, respectively. The 2 patients who underwent double valve replacement are alive and in good condition after a median follow-up of 71 months. Cardiac surgery is indicated in selected patients infected by the human immunodeficiency virus. These patients are frequently drug abusers or homosexual. Valvular endocarditis is the most common finding. Hospital morbidity and mortality rates are higher than usual in this group of patients.


Subject(s)
Cardiac Surgical Procedures , Endocarditis, Bacterial/surgery , HIV Infections/complications , HIV-1 , Pericarditis/surgery , AIDS-Related Opportunistic Infections/surgery , Adult , Aortic Aneurysm/complications , Aortic Aneurysm/surgery , Endocarditis, Bacterial/complications , Humans , Middle Aged , Pericarditis/complications
5.
N Engl J Med ; 332(2): 126; author reply 126-7, 1995 Jan 12.
Article in English | MEDLINE | ID: mdl-7990897
6.
An Med Interna ; 8(4): 170-3, 1991 Apr.
Article in Spanish | MEDLINE | ID: mdl-1912169

ABSTRACT

Hematologic alterations are frequent in SLE. The hematologic changes of 111 patients diagnosed as suffering from SLE are described, associating them to 89 clinical, biological and hystological variables. The most frequent alteration was normocytic and normochromic anemia. Coombs positive hemolytic anemia appeared in 10% of the cases. Approximately 20% of patients had leukopenia. Lymphopenia was observed during the active period of the disease. Mild thrombocytopenia is common, as well as quality changes of the platelets. The sedimentation rate is high in nearly all patients with SLE and this is a non-specific index of the disease activity. These changes have seldom been described in our area.


Subject(s)
Lupus Erythematosus, Systemic/blood , Adolescent , Adult , Aged , Blood Sedimentation , Child , Chronic Disease , Female , Hematocrit , Humans , Leukopenia/blood , Leukopenia/etiology , Lupus Coagulation Inhibitor/blood , Lupus Erythematosus, Systemic/complications , Lymphopenia/blood , Lymphopenia/etiology , Male , Middle Aged , Thrombocytopenia/blood , Thrombocytopenia/etiology
7.
Rev Clin Esp ; 187(7): 346-7, 1990 Nov.
Article in Spanish | MEDLINE | ID: mdl-2091114

ABSTRACT

The appearance of chorea due to systemic lupus erythematosus is extremely rare. A greater frequency of circulating anticoagulant, false positive luetic serology and antiphospholipid antibodies has been recently detected in these patients. For this reason, it has been postulated that these could be involved in the genesis of the chorea through a thrombotic mechanism or autoimmune encephalitis. We describe a case or chorea in a female patient with systemic lupus erythematosus.


Subject(s)
Chorea/etiology , Lupus Erythematosus, Systemic/complications , Adolescent , Chorea/diagnosis , Chorea/drug therapy , Drug Therapy, Combination , Female , Haloperidol/therapeutic use , Humans , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/drug therapy , Prednisone/administration & dosage
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