[Acute coronary syndrome in a young female patient: findings beyond coronary lesions]. / Syndrome coronarien aigu chez une jeune patiente: au-delà des lésions coronaires.

We here report the case of a 47-year old female patient with acute coronary syndrome associated with possible arterial embolism of the right lower limb. During examination we detected G201210A Mutation of the Prothrombin Gene associated with lupus anticoagulant factor.

[Primary antiretroviral drug resistance among patients diagnosed with HIV infection in Gran Canaria (Spain) between 2002 and 2005]. / Resistencias primarias a los fármacos antirretrovirales en los pacientes diagnosticados de infección por el VIH en Gran Canaria entre los años 2002-2005.

BACKGROUND: This study examines the prevalence of primary resistance to antiretroviral drugs in patients diagnosed with HIV infection during 2002 to 2005 and determines the clinical and epidemiological characteristics of this population. METHODS: A prospective analysis of genotypic resistance was carried out in 125 patients by gene sequencing (88.0% diagnosed in 2002, 28.9% in 2003-2004, and 87.9% in 2005). Thirteen patients had a diagnosis of recent primary infection. RESULTS: Sixteen patients (12.8%) carried viruses with at least one drug-resistance mutation; among them, 4 had recent infection (30.8%) and 12 chronic infection or infection of unknown duration (10.7%). Six patients (4.8%) presented at least one resistance mutation to nucleoside/tide reverse transcriptase inhibitors, 9 patients (7.2%) to non-nucleoside/ tide reverse transcriptase inhibitors inhibitors and 2 patients (1.6%) to protease inhibitors. One patient (0.8%) harbored a multidrug-resistant variant. The frequency of primary resistance was higher in patients with HIV subtype B (15.5%), in the homosexual/bisexual population (17.9%), and in patients diagnosed in 2005 (17.9%). Prevalence increased from 9.3% in 2002 to 16.3% in 2005 in chronically infected patients or those with unknown duration of the infection. CONCLUSIONS: Primary resistance to antiretroviral drugs is high in both recent and chronic HIV infection and has increased in recent years. Genotype resistance testing in patients with a diagnosis of HIV infection is recommended before beginning antiretroviral therapy.