RESUMO
HIV-infected patients are at increased risk for acquiring hepatitis A virus (HAV) infection. We evaluated the seroconversion rate (anti-HAV antibodies ≥ 20 mIU/ml) and the geometric mean antibody titres (GMTs) in a group of 351 HIV infected men, who had received two doses of a hepatitis A vaccine. We analysed blood samples collected at one, six, 12 and 18 months following the administration of the second dose of the vaccine. The seroconversion rate one month after the second dose of the vaccine was 74.4% (260/351). At month 18 after the end of vaccination, 56.1% of the subjects remained seropositive. GMTs were 315, 203, 153 and 126 mIU/ml at months 1, 6, 12, and 18, respectively. Logistic regression revealed that the CD4 count is the only factor affecting response to vaccination (P = 0.019). A higher response rate and higher GMTs were observed in patients with CD4 counts ≥ 500 cells/mm(3) (76.6%) than in patients with CD4 counts 200-499 cells/mm(3). In conclusion, even in patients with near-normal CD4 counts, the response to the hepatitis A vaccine is impaired.
Assuntos
Infecções por HIV/imunologia , Vacinas contra Hepatite A/administração & dosagem , Vacinas contra Hepatite A/imunologia , Hepatite A/prevenção & controle , Adulto , Contagem de Linfócito CD4 , Grécia/epidemiologia , HIV/genética , HIV/imunologia , Infecções por HIV/epidemiologia , Infecções por HIV/virologia , Hepatite A/virologia , Anticorpos Anti-Hepatite A/sangue , Homossexualidade Masculina , Humanos , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Estatísticas não Paramétricas , Carga ViralRESUMO
Melanoma is a neoplastic disorder produced by malignant transformation of the normal melanocyte, accounting for 4% of all skin malignancies. This malignancy was described since antiquity as a "fatal black tumour". In the 19th century, the distinguished pathologist Sir Robert Carswell coined first the term melanoma, provided its pathological description and depicted the lesion in his famous work Pathological Anatomy: Illustrations of the elementary forms of disease.
Assuntos
Melanoma/história , Melanoma/patologia , História do Século XVIII , História do Século XIX , HumanosAssuntos
Dermatopatias/epidemiologia , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-IdadeAssuntos
Alopecia em Áreas/epidemiologia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Adulto JovemAssuntos
Dermatopatias Bacterianas/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Estudos Transversais , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , PrevalênciaAssuntos
Psoríase/patologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Doença Crônica , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , PrevalênciaAssuntos
Doenças dos Genitais Femininos/epidemiologia , Doenças dos Genitais Masculinos/epidemiologia , Líquen Escleroso e Atrófico/epidemiologia , Esclerodermia Localizada/epidemiologia , Dermatopatias/epidemiologia , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Distribuição de Qui-Quadrado , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores SexuaisAssuntos
Carcinoma de Células Escamosas/epidemiologia , Neoplasias Cutâneas/epidemiologia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma de Células Escamosas/patologia , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Estudos Transversais , Diagnóstico Diferencial , Feminino , Grécia/epidemiologia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Prevalência , Neoplasias Cutâneas/patologiaRESUMO
Eighty-seven out of 575 gonococci isolated in Greece from 1991 to 1998 belonged to serovar Bropyst and exhibited resistance to penicillin, tetracycline, erythromycin, and chloramphenicol. Conventional and molecular typing showed three clusters, A, B, and C, that were associated with networks of high- frequency transmitters (cluster A with homosexuals and clusters B and C with refugees from Eastern Europe). Study of one isolate revealed mutations in the penA, mtrR, and porB genes that may explain the multidrug-resistant phenotype.
Assuntos
Proteínas de Bactérias , Resistência Microbiana a Medicamentos/fisiologia , Resistência a Múltiplos Medicamentos/fisiologia , Ferredoxina-NADP Redutase , Neisseria gonorrhoeae/fisiologia , Porinas , Antibacterianos/farmacologia , Proteínas da Membrana Bacteriana Externa/genética , Resistência ao Cloranfenicol/genética , Resistência ao Cloranfenicol/fisiologia , Resistência Microbiana a Medicamentos/genética , Resistência a Múltiplos Medicamentos/genética , Eritromicina/farmacologia , Grécia , Humanos , Testes de Sensibilidade Microbiana , Mutação , Neisseria gonorrhoeae/efeitos dos fármacos , Neisseria gonorrhoeae/genética , Resistência às Penicilinas/genética , Resistência às Penicilinas/fisiologia , Proteínas Repressoras/genética , Resistência a Tetraciclina/genética , Resistência a Tetraciclina/fisiologiaRESUMO
The paper attempts to evaluate the clinical and economic benefits between the administration of the dual and triple antiretroic schemes for the treatment of the HIV disease. Clinical and economic data are derived from patients hospitalized in 1996 and 1997 at the University Department of Dermatology and Venereology of Andreas Sygros Hospital. Methodology is based on the comparison of patients' nosological profile and direct annual cost before and after the administration of the triple treatment. The results of the study present that the triple combination therapy yields superior health outcomes, (decrease in the days of hospitalization and in the opportunistic disease events as well as fewer deaths and loss of production). Cost comparison presents a small decrease in the annual patient's cost, where all cost components are diminished, except the medication cost. A substitution of hospital care by drug therapy is revealed and a great change is taken place in the composition of the drugs' cost. Patient cost for antiretroic drugs has more than doubled from 1996 to 1997.
Assuntos
Síndrome da Imunodeficiência Adquirida/economia , Fármacos Anti-HIV/economia , Terapia Antirretroviral de Alta Atividade/economia , Custos de Cuidados de Saúde , Fármacos Anti-HIV/uso terapêutico , Análise Custo-Benefício , Custos de Medicamentos , Grécia , Humanos , Honorários por Prescrição de MedicamentosAssuntos
Carcinoma de Células Escamosas/etiologia , Úlcera da Perna/complicações , Hanseníase Virchowiana/complicações , Neoplasias Cutâneas/etiologia , Idoso , Carcinoma de Células Escamosas/patologia , Transformação Celular Neoplásica , Doença Crônica , Feminino , Humanos , Masculino , Neoplasias Cutâneas/patologiaRESUMO
Hepatitis B surface antigen (HBsAg) seroprevalence among three major groups of sporadic voluntary blood donors in Greece was studied and compared to the seroprevalence in regular donors. These three groups share many characteristics with the general population. A 6-year retrospective seroepidemiological study was carried out (1991-1996). The study population consisted of donors who were (i) military recruits (n = 80 302), (ii) enlisted military personnel (n = 86 920) and (iii) directed family donors (n = 75403). A specimen was considered as HBsAg positive when found repeatedly reactive by a 3rd-generation immunoassay and confirmed by RIA. The Mantel-Haenszel chi2 procedure was used for stratified analysis of the prevalence rates and Greenland/Robins confidence intervals of the respective weighted relative risk (MHRR) were calculated. The 6-year overall HBsAg seroprevalence among the three sporadic donor groups was 0.84%; this was twice the seroprevalence among a sample of regular donors (n = 45504) in Greece. Seroprevalence was higher among enlisted personnel (1.21 < MHRR = 1.34 < 1.50), during years prior to 1995. Directed family donors had the same overall seropositivity rate as recruits and enlisted personnel. After 1995, all groups had a seroprevalence below 1%, possibly indicating a shift towards lower endemicity in the Greek population.
Assuntos
Doadores de Sangue/estatística & dados numéricos , Antígenos de Superfície da Hepatite B/sangue , Adolescente , Adulto , Idoso , Distribuição de Qui-Quadrado , Intervalos de Confiança , Família , Feminino , Grécia/epidemiologia , Hepatite B/epidemiologia , Hepatite B/transmissão , Humanos , Imunoensaio , Masculino , Pessoa de Meia-Idade , Militares , Modelos Estatísticos , Estudos Retrospectivos , Estudos SoroepidemiológicosRESUMO
The case of an AIDS patient with cytomegalovirus (CMV) retinitis who was treated with cidofovir for 17 consecutive months, without any adverse effect, is presented. In the context of antiretroviral therapy, cidofovir therapeutic regimen was 5 mg/kg of body weight for 2 weeks and 5 mg/kg thereafter every other week. Probenecid, hydration and monitoring for proteinuria were also used to prevent nephrotoxicity. The patient stopped maintenance therapy for CMV retinitis after the permanent rise of CD4+ cells above 100 c/mm3. For more than 10 months after drug withdrawal the patient remains free of retinitis.
