ABSTRACT
BACKGROUND: Kaposi sarcoma is the most common tumor in HIV infected patients. AIM: To describe a cohort of patients with Kaposi sarcoma. MATERIAL AND METHODS: Retrospective review of HIV patients with Kaposi sarcoma seen at a public hospital and at a HIV clinic. Detailed description of patients subjected to antiretroviral treatment and chemotherapy. RESULTS: Between 1995 and 2002, 1127 HIV infected patients were seen. Of these, 78 had Kaposi sarcoma, 15 were treated with high activity antiretroviral therapy (HAART) and 17 with HAART and chemotherapy. These 32 patients were male, and their mean age was 33 +/- 6 years. The initial CD4 count in 27 of these was 95 +/- 105 cells/ml. The initial viral load in 18 of these was 370,246 +/- 768,693 RNA copies/ml. Of the 15 patients treated with HAART, eight had a complete remission, one had a partial response, one remained stationary and five died. Of the 17 patients treated with HAART and chemotherapy, seven had complete remission, five had a partial response, 2 remained stationary and three died. The lapse of complete remission was 272 days for those treated with HAART and 292 days for those treated with HAART and chemotherapy. CONCLUSIONS: In HIV patients with Kaposi sarcoma, high activity antiretroviral therapy, associated or not to chemotherapy, induces complete remission in 46 per cent of patients and partial remission in 16 per cent.
Subject(s)
Humans , Male , Middle Aged , Anti-HIV Agents/therapeutic use , HIV Infections/complications , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Sarcoma, Kaposi/drug therapy , Antiretroviral Therapy, Highly Active , Viral Load , Retrospective Studies , Time Factors , AIDS-Related Opportunistic Infections/drug therapy , AIDS-Related Opportunistic Infections/pathology , HIV Infections/mortality , Reverse Transcriptase Inhibitors/therapeutic use , Drug Therapy, Combination , Sarcoma, Kaposi/etiology , Sarcoma, Kaposi/radiotherapyABSTRACT
We report two male patients with AIDS, aged 23 and 30 years old respectively. One was admitted due to a progressive weakness of the left leg and urinary and fecal incontinence. The other was admitted due to a progressive paraparesia without incontinence, but with a severe lumbar pain. In both patients polymerase chain reactions for cytomegalovirus in cerebrospinal fluid were positive. Treatment with ganciclovir, for 21 and 14 days respectively and highly active antiretroviral therapy was started. Both patients experienced recovery of their neurological deficits after 98 and 88 days of therapy, respectively.
Subject(s)
AIDS-Related Opportunistic Infections/drug therapy , Antiretroviral Therapy, Highly Active , Antiviral Agents/therapeutic use , Cytomegalovirus Infections/drug therapy , Ganciclovir/therapeutic use , Polyradiculopathy/drug therapy , Adult , Cytomegalovirus Infections/cerebrospinal fluid , Cytomegalovirus Infections/complications , HIV Infections/drug therapy , Humans , Male , Polymerase Chain Reaction , Polyradiculopathy/virologySubject(s)
Hospital Bed Capacity , Hospitalization/trends , Patients' Rooms , Chile , Humans , Time FactorsABSTRACT
La tuberculosis es una enfermedad de alta prevalencia. Sería de gran utilidad disponer de un método serológico principalmente en los casos que son positivos sólo por cultivo que demora 30 a 60 días. El inconveniente de la serología radica en la interpretación de los resultados, por lo que se requiere una cuidadosa evaluación de la utilidad clínica del test en un área determinada. Con el objetivo de implementar y determinar la utilidad clínica del diagnóstico serológico de TBC, se estudiaron los sueros de 101 pacientes divididos en 4 grupos; grupo 1: 26 controles sanos, grupo 2: 25 pacientes con patología pulmonar no TBC, grupo 3: 27 tuberculosos baciloscopia (+) y grupo 4: 2 tuberculosos sólo cultivo (+). Se determinó IgG, IgM y IgA anti antígeno A60 por un ELISA indirecto cenocial. Se calculó para cada suero la sumatoria de las 3 clases de inmunoglobulinas y se estableció un punto de corte de 0,45 absorvancia. La sensibilidad para grupo 4 fue de 78 por ciento y la específidad para grupo 2 fue de 88 por ciento. Con estos resultados la aplicación del test como screening de TBC resulta no recomendable con un alto número de falsos (+) que lleva a tratamientos prolongados e innecesarios. En cambio, el test sería de gran utilidad si se emplea en pacientes hospitalizados, en los que se descarten patologías de diagnóstico diferencial de TBC (cáncer, neumonías, cavitarias, etc). A medida que se va descartando otras patologías, (probabilidad pre-test) va aumentando con lo cual el valor predictivo positivo del examen mejora significativamente: si la probabilidad pre-test es 0,3, el valor predictivo positivo es de 74 por ciento y si la probabilidad pre-test es de 0,7, el valor predictivo positivo aumenta a 94 por ciento. En conclusión, el test de ELISA anti-antígeno A60 sería de gran utilidad como otro elemento de apoyo en pacientes con alta probabilidad clínica de TBC y microbiología negativa
Subject(s)
Humans , Enzyme-Linked Immunosorbent Assay/statistics & numerical data , Serologic Tests , Tuberculosis/diagnosis , Blood Chemical Analysis , Case-Control Studies , Immunoglobulins/blood , Predictive Value of Tests , Sensitivity and SpecificityABSTRACT
An inquest to determine the degree of knowledge they have, was done among 27 physicians (obstetricians-gynecologist), 36 midwives and 47 assistants of infirmary in a maternity of Santiago. The following items where included: definition of concept, general knowledge, ways of transmission, prevention and treatment, communication and educational means, recommendations, comments, suggestions and specific knowledge. We proved that even though the general knowledge is apparently good for physicians, midwives and assistants of infirmary, they don't have adequate knowledge of the mechanisms of transmission of AIDS, of its prevention and no specific knowledge. They do have wrong ideas upon the topic. This lack is evident in assistants of infirmary and in a less degree in midwives and physicians. Considering that the group to be studied works in the specific health area dealing with gynecology and obstetrics, it is expected that they have a high grade of knowledge in relation with AIDS, due to the fact that they are a group of high risk in getting the disease and that they are a multiplicator factor of education among the population. This makes necessary to give periodic training courses and to reinforce the knowledge of such personnel.
Subject(s)
Acquired Immunodeficiency Syndrome , Health Knowledge, Attitudes, Practice , Adult , Chile , Female , Hospitals, Maternity , Humans , Male , Medical Staff, Hospital , Middle Aged , Nurse Midwives , Nursing AssistantsABSTRACT
Se presenta en forma esquemática los métodos de antisepsia contra el virus de la inmunodeficiencia humana (VIH), junto a medidas de protección generales en el hogar de un infectado o enfermo de SIDA
Subject(s)
Antisepsis , Sterilization/methods , Acquired Immunodeficiency Syndrome/prevention & controlABSTRACT
El edema pulmonar agudo de altura, se produce sobre 2.500 metros de altura, especialmente en ninos y adolescentes susceptibles y residentes o nativos de altura, que ascienden sin periodo previo de aclimatacion desde el nivel del mar, desencadenado por la disminucion de la PO2 atmosferica lo que representa una desadaptacion a las nuevas condiciones, con respuesta favorable a la terapeutica exclusiva de oxigeno y reposo o descenso rapido
