ABSTRACT
BACKGROUND: Diabetes mellitus is known to be associated with worse clinical outcomes in patients with coronary artery disease (CAD) undergoing percutaneous coronary interventions (PCI) with drug-eluting stents (DES). Defining the optimal duration of dual antiplatelet therapy (DAPT) after DES implantation is still under debate. The objective of this subgroup analysis of the all-comers ISAR 2000 registry was to assess the safety and efficacy of a short DAPT (<6 month) versus a longer DAPT (>6 month) in patients with diabetes electively treated with the polymer-free sirolimus-coated ultrathin strut drug-eluting stent (PF-SES). METHODS: Patients who received the PF-SES were investigated in a multicenter all-comers observational study. The primary endpoint was the 9month target lesion revascularization (TLR) rate, whereas secondary endpoints included the 9month major adverse cardiac event (MACE) and procedural success rates. RESULTS: In all, 167 patients were treated with DAPT for ≤6 months (S-DAPT group) and 350 patients underwent DAPT treatment for 12 months (L-DAPT group). There was no significant difference in the overall MACE rate (4.6% vs. 3.1%, pâ¯= 0.441), the 9month accumulated stent thrombosis rates (0.8% vs. 0.3%, pâ¯= 0.51), or the accumulated rate of bleeding complications (5.3% vs. 3.4%, pâ¯= 0.341). CONCLUSION: PF-SES are safe and effective in daily clinical routine with low rates of TLR and MACE in patients with diabetes and stable disease. Our data suggest that extending the duration of DAPT beyond 6 months does not improve MACE or TLR at 9 months in patients with stable CAD (ClinicalTrials.gov Identifier NCT02629575).
Subject(s)
Coronary Artery Disease , Diabetes Mellitus , Drug-Eluting Stents , Percutaneous Coronary Intervention , Platelet Aggregation Inhibitors , Sirolimus , Coronary Artery Disease/drug therapy , Diabetes Complications , Dinucleoside Phosphates , Humans , Male , Platelet Aggregation Inhibitors/therapeutic use , Polymers , Sirolimus/administration & dosage , Treatment OutcomeABSTRACT
No disponible
Subject(s)
Humans , Male , Aged , Angina, Unstable/complications , Catheterization/instrumentation , Catheterization/methods , Cardiac Catheterization/methods , Cardiac Catheterization , Tropicamide/therapeutic use , Retina/pathology , Retina , Echocardiography/methods , Ophthalmoscopy/methods , Ophthalmoscopy , Angioplasty/methods , Angioplasty , Retina/anatomy & histology , Retina/physiopathologyABSTRACT
BACKGROUND: Liver enzyme elevation (LEE) as a consequence of HAART is a problem among patients with HIV-HCV co-infection. METHODS: In this retrospective study, 145 patients with HIV who were on HAART and who developed LEE grades 3 and 4 of the World Health Organization (WHO) were followed up. Basal ALT, alcohol consumption, and HCV and HBV co-infection were recorded. Comparisons were made between patients with and without HCV co-infection. RESULTS: Three patients without co-infection presented LEE grade 3 versus 38 with co-infection (104 episodes). An increase in basal ALT (RR: 1.01) and HCV co-infection (RR: 6.6) were the variables associated with LEE grade 3. The number of days that HAART had to be withdrawn due to LEE was 58.15 and 4.85 in subjects with and without co-infection, respectively (p=0.024). CONCLUSION: Patients with HCV-HIV co-infection have more episodes of LEE and must go longer without HAART than people without co-infection.
ABSTRACT
No disponible
Subject(s)
Aged , Male , Humans , HIV-1 , HIV Infections , Anti-HIV Agents , Research Design , Random Allocation , Purpura, Thrombotic Thrombocytopenic , Carcinoma, Hepatocellular , Randomized Controlled Trials as Topic , Bone Neoplasms , Liver NeoplasmsABSTRACT
Cytokines are a group of hormone-like polypeptides that play a variety of regulatory roles in host defense against infection. Because of the possible different involvement of these mediators in bacterial infections and tuberculosis, enzyme immunoassay was used to measure comparatively the plasma levels of the proinflammatory cytokines interleukin-1 beta (IL-1beta), tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6) and interferon gamma (IFN-gamma) in 25 immunocompetent patients divided into two groups: in 12 patients clinical and microbiological diagnosis showed a chronic bacterial infection and 13 patients had pleuropulmonar tuberculosis. After resolution of the infectious disorders (> or = 3 months), these measurements were repeated for each patient. High levels of IL-1b, TNF-alpha and IL-6 were observed at study entry, but no significant difference was found between the groups. In contrast, plasma levels (mean +/- SEM) of IFN-gamma were significantly higher in patients with tuberculosis when compared with the bacterial group (0.753 +/- 0.201 vs 0.325 +/- 0.105 IU/ml; P = 0.020). This different pattern of plasma proinflammatory cytokines could be ascribed to a prevaling role of the mediators of so-called Th-1 immune response (IFN-gamma) in host defense against infection with Mycobacterium tuberculosis.
Subject(s)
Bacterial Infections/blood , Cytokines/blood , Tuberculosis, Pulmonary/blood , Adult , Bacterial Infections/microbiology , Biomarkers/blood , Chronic Disease , Cytokines/analysis , Enzyme-Linked Immunosorbent Assay , Female , Humans , Interferon-gamma/blood , Interleukin-1/blood , Interleukin-6/blood , Male , Middle Aged , Probability , Sensitivity and Specificity , Statistics, Nonparametric , Tumor Necrosis Factor-alpha/analysisABSTRACT
We describe a method based on isotope analysis (δ(13)C) for characterization and differentiation of Iberian pork meat as a function of the diet of the animal. Using adipose tissue, it is possible to classify unknown samples in group of animals designated "acorn-fed", "recebo=mixed-fed" and "feed raised" according the δ(13)C value obtained, from the calibration straight line of y=-22.12-0.35x, with a correlation coefficient r=0.982 and s=0.1; where y=δ(13)C and x=arrobas of acorn and range forage received by the animals during the fattening period. Stress should be placed on the economic and industrial importance of Iberian-breed swine because the market prices of Iberian swine products depends on the classification of the animals according to the type of feeding regimen which they are subjected to.
ABSTRACT
Histoplasma infections in Europe are rare, and acute disseminated histoplasmosis has been observed only in immunocompromised persons. An unusual case of autochthonous disseminated histoplasmosis in a 22-year-old Spanish man who had been treated with azathioprine and prednisone for 4 weeks before admission is reported. The development of an acute form of the disease may represent an endogenous reactivation of a latent infection as a complication of immunosuppression resulting from the use of these drugs. This case illustrates the potential risk of this opportunistic fungal infection in patients receiving azathioprine therapy, an association that has been rarely described before.
Subject(s)
Amphotericin B/administration & dosage , Antifungal Agents/administration & dosage , Azathioprine/adverse effects , Histoplasmosis/drug therapy , Immunosuppressive Agents/adverse effects , Opportunistic Infections/drug therapy , Adult , Amphotericin B/therapeutic use , Antifungal Agents/therapeutic use , Bone Marrow Cells/microbiology , Drug Carriers , Drug Therapy, Combination , Histoplasma/isolation & purification , Humans , Immunosuppression Therapy , Liposomes , Lymph Nodes/microbiology , Male , Prednisone/adverse effectsSubject(s)
Immunologic Factors/therapeutic use , Interferon-alpha/therapeutic use , Mastocytosis/complications , Primary Myelofibrosis/etiology , Bone Marrow/pathology , Cerebral Hemorrhage/etiology , Combined Modality Therapy , Fatal Outcome , Female , Histamine Antagonists/therapeutic use , Humans , Interferon alpha-2 , Ketotifen/therapeutic use , Mastocytosis/drug therapy , Mastocytosis/pathology , Mastocytosis/surgery , Mastocytosis/therapy , Middle Aged , Prednisone/therapeutic use , Primary Myelofibrosis/pathology , Prognosis , Recombinant Proteins , SplenectomyABSTRACT
We report a case of systemic polyarteritis nodosa (PAN) leading to the discovery of an as yet asymptomatic, surgically curable gastric adenocarcinoma. PAN is rarely associated with malignancies and in such cases these are more often malignant haematological diseases than solid neoplasms. The immunopathological findings, the temporal relationship between both conditions, and the spontaneous resolution of vasculitis after tumour removal suggest a paraneoplastic origin of the systemic angitis.
Subject(s)
Adenocarcinoma/diagnosis , Polyarteritis Nodosa/etiology , Stomach Neoplasms/diagnosis , Adenocarcinoma/complications , Adenocarcinoma/pathology , Adenocarcinoma/physiopathology , Humans , Male , Middle Aged , Polyarteritis Nodosa/pathology , Polyarteritis Nodosa/physiopathology , Stomach Neoplasms/complications , Stomach Neoplasms/pathology , Stomach Neoplasms/physiopathologyABSTRACT
This study attempts to evaluate the adequacy of the erythropoietin (EPO) response in 42 anaemic patients with advanced human immunodeficiency virus (HIV) infection [30 with acquired immunodeficiency syndrome (AIDS) and 12 with AIDS-related conditions] by comparing their serum EPO levels with those found in a non-HIV reference population consisting of 36 patients with anaemia of chronic disorders (ACD) and 57 with iron deficiency anaemia (IDA). Although the average Hb concentration was similar in the three groups, the EPO level for HIV patients (mean +/- SEM, 64.3 +/- 7.7 mU/ml) did not differ significantly from that in ACD patients (45.3 +/- 8.3 mU/ml, P > 0.1), and both groups had a lower mean EPO level (P < 0.05 and P < 0.01 respectively) than IDA subjects (133.5 +/- 18.7 mU/ml). Thirteen HIV patients on zidovudine therapy showed similar mean Hb and EPO levels to those in the untreated patients. A significant inverse correlation between the log of serum EPO and the Hb values was observed in the three groups. However, this relationship was found to be stronger in IDA patients than in either HIV or ACD subjects (P < 0.001), with no difference between the two latter groups (P > 0.2). These data suggest that the EPO response is blunted in the anaemia associated with advanced HIV infection.
Subject(s)
Anemia/blood , Erythropoietin/blood , HIV Infections/blood , Acquired Immunodeficiency Syndrome/blood , Acute-Phase Reaction/blood , Adolescent , Adult , Aged , Anemia/complications , Anemia, Hypochromic/blood , Child , Chronic Disease , Female , HIV Infections/complications , Hemoglobins/analysis , Humans , Male , Middle AgedABSTRACT
Two patients with chronic neutrophilic leukemia, a rare myeloproliferative syndrome, are reported with a review of the literature. The major features of the 34 collected cases (including the two patients reported here) were persistent leukocytosis simulating a leukemoid reaction, hepatosplenomegaly, hyperuricemia, increased vitamin B12 blood level, increased leukocyte alkaline phosphatase and absence of the Philadelphia chromosome. Infection was the leading cause of death. Concomitant multiple myeloma was found in eight patients.
