ABSTRACT
No disponible
Subject(s)
Adult , Humans , Male , Arterial Occlusive Diseases/etiology , Cryoglobulinemia/physiopathology , Multiple Myeloma/complications , Plasmapheresis , Alprostadil/therapeutic use , Skin Ulcer/etiologyABSTRACT
No disponible
Subject(s)
Humans , Female , Aged , Tuberculosis, Cutaneous/diagnosis , Tuberculosis, Female Genital/diagnosis , Vulvar Diseases/diagnosis , Mycobacterium tuberculosis/isolation & purificationABSTRACT
OBJECTIVE: To analyze the impact of highly active anti-retroviral therapy (HAART) on the admissions and mortality of patients with human immunodeficiency virus (HIV) infection and of all patients cared in an Internal Medicine Department. METHODS: A retrospective study with analysis of admissions and deaths in the Internal Medicine Department of a third-level care hospital between January 1996 and December 2000. HAART was introduced starting in 1997. Age, gender, main diagnosis at discharge, diagnosis related group (DRG) weight, death cause, and hospital stay were assessed globally and annually. RESULTS: During the study period 7,580 admissions took place, of which 939 were secondary to HIV infection related diseases. The incidence of HIV-related admissions declined in 32.9% and the case-fatality rate in 67.8% between 1996 and 2000, with increase at the same time of the number of patients with noninfectious respiratory pathology and of overall number of patients with infections. Average hospital stay of patients cared in the Internal Medicine Department remained stable, with reduction of 31.5% of that of the group with HIV infection starting in 1997. DRG complexity in this group decreased 0.56 points. CONCLUSIONS: The introduction of HAART has been associated to a reduction in the incidence of admissions, in the complexity of the diagnoses, and in the mortality in the group of patients with HIV infection. At the same time there was an increased in the number of patients with respiratory and infectious pathology different from that related to HIV.
Subject(s)
Antiretroviral Therapy, Highly Active , HIV Infections , Hospital Mortality , Hospitalization/statistics & numerical data , Female , HIV Infections/complications , HIV Infections/therapy , Humans , Internal Medicine , Male , Retrospective Studies , SpainABSTRACT
Objetivo. Analizar la repercusión de la terapia antirretroviral de gran actividad (TARGA) sobre los ingresos y mortalidad de los pacientes con infección por el virus de la inmunodeficiencia humana (VIH) en particular y sobre un Servicio de Medicina Interna en general. Métodos. Estudio retrospectivo que analiza los ingresos y éxitus producidos en el Servicio de Medicina Interna de un hospital de especialidades entre enero de 1996 y diciembre de 2000. La TARGA se introdujo a partir de 1997. Se valoraron edad, género, diagnóstico principal al alta, peso del grupo relacionado con el diagnóstico (GDR), causa de la muerte y estancia hospitalaria de forma global y distribuidas anualmente. Resultados. Durante el período se produjeron 7.580 ingresos, de los cuales 939 estuvieron producidos por patologías relacionadas con la infección por el VIH. El número de ingresos por VIH disminuyó en un 32,9% y la tasa de letalidad en un 67,8% entre 1996 y 2000, aumentando el volumen de pacientes con patología respiratoria no infecciosa e infecciones en general. La estancia media de los pacientes ingresados en el servicio se mantuvo estable, disminuyendo la del grupo con infección por el VIH un 31,5% a partir de 1997. La complejidad de los GDR en este grupo disminuyó 0,56 puntos. Conclusiones. La introducción de la TARGA se ha relacionado con una disminución en el número de ingresos, complejidad de los diagnósticos y fallecimientos en el grupo de pacientes con infección por el VIH. Ese lugar ha sido ocupado por enfermos con patología respiratoria e infecciosa diferente a la relacionada con el VIH
Objective. To analyze the impact of highly active anti-retroviral therapy (HAART) on the admissions and mortality of patients with human immunodeficiency virus (HIV) infection and of all patients cared in an Internal Medicine Department. Methods. A retrospective study with analysis of admissions and deaths in the Internal Medicine Department of a third-level care hospital between January 1996 and December 2000. HAART was introduced starting in 1997. Age, gender, main diagnosis at discharge, diagnosis related group (DRG) weight, death cause, and hospital stay were assessed globally and annually. Results. During the study period 7,580 admissions took place, of which 939 were secondary to HIV infection related diseases. The incidence of HIV-related admissions declined in 32.9% and the case-fatality rate in 67.8% between 1996 and 2000, with increase at the same time of the number of patients with noninfectious respiratory pathology and of overall number of patients with infections. Average hospital stay of patients cared in the Internal Medicine Department remained stable, with reduction of 31.5% of that of the group with HIV infection starting in 1997. DRG complexity in this group decreased 0.56 points. Conclusions. The introduction of HAART has been associated to a reduction in the incidence of admissions, in the complexity of the diagnoses, and in the mortality in the group of patients with HIV infection. At the same time there was an increased in the number of patients with respiratory and infectious pathology different from that related to HIV
Subject(s)
Male , Female , Humans , Antiretroviral Therapy, Highly Active , HIV Infections/complications , HIV Infections/therapy , Hospital Mortality , Hospitalization/statistics & numerical data , Internal Medicine , Retrospective Studies , SpainABSTRACT
No disponible
Subject(s)
Adult , Humans , Streptococcus pneumoniae , Viral Vaccines , HIV Infections , Haemophilus influenzae type b , Bacterial Vaccines , Influenza Vaccines , Influenza VaccinesSubject(s)
Bacterial Vaccines/immunology , HIV Infections/immunology , Adult , Bacterial Vaccines/administration & dosage , Haemophilus influenzae type b/immunology , Humans , Influenza Vaccines/administration & dosage , Influenza Vaccines/immunology , Streptococcus pneumoniae/immunology , Viral Vaccines/administration & dosage , Viral Vaccines/immunologyABSTRACT
In order to analyze the nutritional status of HIV infected patients and the involvement of the tumour necrosis factor-alpha (TNF-alpha) and its soluble receptors (sTNFRI and sTNFRII) in such an status, forty HIV infected patients, with no associated systemic opportunist infections, were prospectively followed for eight months. From each patient the following were obtained: clinical history, dietetic survey, anthropometric measurements, CD4+ T lymphocyte/mm3 count, HIV load, and serum concentration of TNF and sTNFRI and sTNFRII. Patients showed a nutritional disorder which involved mainly the fat compartment (mean tricipital skin fold 9.8 +/- 4.2 mm, that is, 65.7 +/- 27.4% of the ideal fold), associated with a hypocaloric intake (mean daily intake 1,659.5 +/- 543.0 kcal), with normal proportions of the different organic principles. Serum concentrations of TNF (87.9 +/- 79.2 vs 8.7 +/- 6.1 pg/ml, p = 0.048) and its receptors, sTNFRI (6.1 +/- 2.6 vs 1.0 +/- 0.8 pg/ml, p < 0.001) and sTNFRII (41.9 +/- 18.6 vs 6.3 +/- 3.6 pg/ml, p < 0.001) were significantly higher than those detected in a sample of ten healthy controls. No correlation was found between nutritional alterations and concentrations of TNF or its receptors, viral load, and counts of CD4+ T lymphocytes/mm3. Seventeen patients completed the follow-up period. During this period, no significant modifications in the analyzed parameters were observed: tricipital skin fold, arm circumference, serum concentrations of albumin or transferrin, concentrations of tumoral necrosis factor or its receptor and caloric intake. The conclusion is that, despite the detected nutritional alterations in the nutritional status and those in the TNF/receptor system, our data no support and interrelationship between them.
