Asunto(s)
Seropositividad para VIH/tratamiento farmacológico , Zidovudina/uso terapéutico , Antiinfecciosos/uso terapéutico , Encéfalo/fisiopatología , Niño , Resultado Fatal , Seropositividad para VIH/fisiopatología , Humanos , Masculino , Fenotipo , Infecciones por Pneumocystis/tratamiento farmacológico , Infecciones por Pneumocystis/prevención & control , Tomografía Computarizada por Rayos X , Combinación Trimetoprim y Sulfametoxazol/uso terapéutico , Zidovudina/administración & dosificaciónRESUMEN
OBJECTIVE: The aim of this study was to analyze the prognostic value of the clinical manifestations and of the lymphocyte CD4 count in a cohort of HIV infected children. PATIENTS AND METHODS: We performed a prospective study in 37 HIV infected children during a 6 year period. We studied the statistical association between mortality and clinical and immunological parameters according to Fisher's test (p < 0.05). We performed a survival analysis according to Kaplan-Meier curves (p < 0.05). RESULTS: We have found that a high risk of mortality is associated with recurrent and severe bacterial infections (p = 0.0001), failure to thrive (p = 0.0057), opportunistic infections (p = 0.0008) and AIDS (p < 0.0001). The survival analysis has shown a low probability of survival in HIV-encephalopathy (p = 0.000053) and high in one case of lymphocytic interstitial pneumonia (p = 0.07). An age-related CD4 count less than 2 SD was associated significantly with a bad prognosis (p = 0 .0017). CONCLUSIONS: The clinical manifestations and age-matched CD4 count continue being good surrogate markers for the indication of prophylaxis, antiretroviral treatment and as prognostic values of the disease in HIV infected children until new techniques, especially plasma viremia, can be widely available.
Asunto(s)
Antígenos CD4/sangre , Seropositividad para VIH/sangre , Seropositividad para VIH/inmunología , Síndrome de Inmunodeficiencia Adquirida/mortalidad , Adolescente , Distribución por Edad , Niño , Preescolar , Progresión de la Enfermedad , Femenino , Seropositividad para VIH/tratamiento farmacológico , Humanos , Lactante , Estudios Longitudinales , Masculino , Pronóstico , Estudios Prospectivos , Factores de Riesgo , Tasa de SupervivenciaAsunto(s)
Cefotaxima/antagonistas & inhibidores , Cefalosporinas/antagonistas & inhibidores , Meningitis Neumocócica/etiología , Streptococcus pneumoniae/efectos de los fármacos , Antibacterianos/administración & dosificación , Farmacorresistencia Microbiana , Quimioterapia Combinada/uso terapéutico , Femenino , Humanos , Lactante , Meningitis Neumocócica/diagnóstico , Meningitis Neumocócica/tratamiento farmacológico , Rifampin/administración & dosificación , Vancomicina/administración & dosificaciónRESUMEN
UNLABELLED: The objective of this study was to evaluate the efficacy of halofantrine in the treatment of malaria caused by Plasmodium falciparum since the resistance of these plasmodium to chloroquine is increasing in countries of Western Africa. MATERIAL AND METHOD: Between January 1991 and June 1994 we studied 50 children from Equatorial Guinea. All of them were black and between the ages of 8 months and 13 years. They were treated with 3 doses of halofantrine (8 mg/kg every 6 hours). The definitive diagnosis was made by the demonstration of the parasites on thick and thin blood smears, stained by standard methods, repeated every 24-72 yours after therapy. We considered the disappearance of fever and the clearance of plasmodium from the red blood cells as signs of response to the treatment. We also monitored the tolerance and the adverse side effects of the drug. RESULTS: All of the patients responded favorably with the disappearance of the fever after 24 hours and after 72 hours no parasites were seen in red blood cells. Only one patient had a recurrence, which occurred on the 10th day. All patient satisfactorily tolerated the drug and only 3 children showed an increase of aminotransferases that was spontaneously cured. CONCLUSIONS: We conclude that halofantrine is a safe and efficient drug for the treatment of children diagnosed with malaria caused by Plasmodium falciparum.
Asunto(s)
Antimaláricos/uso terapéutico , Malaria Falciparum/tratamiento farmacológico , Fenantrenos/uso terapéutico , Adolescente , Antimaláricos/efectos adversos , Niño , Preescolar , Evaluación de Medicamentos , Guinea Ecuatorial/etnología , Femenino , Humanos , Lactante , Malaria Falciparum/sangre , Masculino , Nigeria/etnología , Fenantrenos/efectos adversos , Inducción de Remisión , EspañaAsunto(s)
Gonorrea/microbiología , Neisseria gonorrhoeae/aislamiento & purificación , Niño , Exantema/etiología , Femenino , Gonorrea/diagnóstico , Gonorrea/tratamiento farmacológico , Gonorrea/etiología , Humanos , Neisseria gonorrhoeae/efectos de los fármacos , Penicilina G/uso terapéutico , Prurito/etiologíaAsunto(s)
Hepatitis A/fisiopatología , Enfermedad Aguda , Adolescente , Niño , Femenino , Humanos , Pruebas de Función Hepática , RecurrenciaRESUMEN
It's known that there has been a resurgence of malaria in the world. Purpose of this article is to point out the increase in number of cases of imported malaria in children in Spain. Authors performed a clinical study and review up to date treatment and prophylaxis of the disease. They communicate cases of three children infected by Plasmodium falciparum resistant to chloroquine, proceeding from areas that up to one year ago were considered to be not resistant. Data published on prevention and selective primary health care of malaria in the world are revised.