RESUMEN
The present study aimed to investigate lymphocyte mobilization from peripheral cell reservoirs in HIV-infected patients. Nine HIV-infected patients on stable highly active anti-retroviral therapy (HAART), eight treatment-naive HIV-infected patients and eight HIV- controls received a 1-h adrenaline infusion. The adrenaline infusion induced a three-fold increase in the concentration of lymphocytes in all three groups. All HIV-infected patients mobilized significantly higher numbers of CD8+ cells but less CD4+ cells. All subjects mobilized CD45RA+CD62L+ and CD8+CD28+ cells to a lesser extent than CD45RO+CD45RA- and CD8+CD28-cells. Furthermore, high numbers of CD8+CD38+ cells were mobilized only in the HIV-infected patients. It was therefore predominantly T cells with an activated phenotype which were mobilized after adrenaline stimulation. It is concluded that the HIV-associated immune defect induced an impaired ability to mobilize immune-competent cells in response to stress stimuli. Furthermore, the study does not support the idea that CD4+ T cells are trapped in lymph nodes by HIV antigens, because untreated and HAART-treated HIV-infected patients mobilized similar numbers of CD4+ T cells. Finally, no evidence was found for the existence of a HAART-induced non-circulating pool of CD4+ T cells.
Asunto(s)
Antígenos CD , Epinefrina/farmacología , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/inmunología , Subgrupos de Linfocitos T/efectos de los fármacos , Subgrupos de Linfocitos T/inmunología , ADP-Ribosil Ciclasa , ADP-Ribosil Ciclasa 1 , Adulto , Fármacos Anti-VIH/uso terapéutico , Antígenos de Diferenciación/metabolismo , Antígenos CD28/metabolismo , Linfocitos T CD4-Positivos/efectos de los fármacos , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD8-positivos/efectos de los fármacos , Linfocitos T CD8-positivos/inmunología , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Glicoproteínas de Membrana , Persona de Mediana Edad , NAD+ Nucleosidasa/metabolismoRESUMEN
Dog bites may result in serious bacterial infections with e.g. the gram-negative rods Capnocytophaga canimorsus and Pasteurella multocida. Human disease caused by these microorganisms can be complicated by acute development of septicaemia and/or meningitis followed by disseminated intravascular coagulation syndrome, peripheral gangrene and renal failure. The mortality of C. canimorsus septicaemia is about 23-31%. These severe infections are most often reported in immunocompromised patients and occur a few days after the bite. By reviewing the literature it is concluded that the broadest prophylactic coverage is obtained by amoxicillin/clavulanic acid and that antibiotic prophylaxis should be given to all immunocompromised patients experiencing a dog bite. Moreover, prophylactic treatment should be initiated for all patients with greater penetrating wounds and those involving the hands.
Asunto(s)
Infecciones Bacterianas/transmisión , Mordeduras y Picaduras/complicaciones , Infección de Heridas/microbiología , Animales , Profilaxis Antibiótica , Bacterias Aerobias/aislamiento & purificación , Bacterias Anaerobias/aislamiento & purificación , Infecciones Bacterianas/microbiología , Infecciones Bacterianas/prevención & control , Mordeduras y Picaduras/microbiología , Perros , Humanos , Pronóstico , Factores de Riesgo , Infección de Heridas/prevención & controlRESUMEN
One case of life-threatening disease caused by the gram-negative rod Capnocytophaga canimorsus and a similar case without verification are presented. The severe diseases developed two to three days after a superficial dog bite and were characterized by acute development of septicaemia and fulminant disseminated intravascular coagulation syndrome. Moreover, the cases were complicated by renal failure, respiratory insufficiency and peripheral gangrene.
Asunto(s)
Mordeduras y Picaduras/complicaciones , Gangrena/microbiología , Infecciones por Bacterias Gramnegativas/complicaciones , Insuficiencia Multiorgánica/etiología , Infección de Heridas/microbiología , Lesión Renal Aguda/etiología , Lesión Renal Aguda/microbiología , Lesión Renal Aguda/terapia , Animales , Antibacterianos/administración & dosificación , Mordeduras y Picaduras/microbiología , Mordeduras y Picaduras/terapia , Capnocytophaga/aislamiento & purificación , Coagulación Intravascular Diseminada/tratamiento farmacológico , Coagulación Intravascular Diseminada/etiología , Coagulación Intravascular Diseminada/microbiología , Perros , Femenino , Gangrena/cirugía , Infecciones por Bacterias Gramnegativas/tratamiento farmacológico , Infecciones por Bacterias Gramnegativas/microbiología , Humanos , Masculino , Persona de Mediana Edad , Insuficiencia Multiorgánica/microbiología , Insuficiencia Multiorgánica/terapia , Insuficiencia Respiratoria/etiología , Insuficiencia Respiratoria/microbiología , Insuficiencia Respiratoria/terapia , Sepsis/tratamiento farmacológico , Sepsis/microbiología , Infección de Heridas/tratamiento farmacológicoRESUMEN
Eleven percent (N = 25) of 232 dementia patients seen in an active geropsychiatry service also met criteria for major depression. Ten patients with dementia/depression were prospectively compared with 10 non-depressed demented and 33 nondemented depressed patients on pretreatment and posttreatment ratings of depression and cognition/memory. Seventy percent (N = 7) of the dementia/depression group and 73% (N = 24) of the depression-only group responded to antidepressant therapy. Signs and symptoms of depression complicating dementia were similar to depressive phenomena in the depression-only group. Depression with dementia appeared to lower performance on cognitive tests. Following treatment, although cognitive impairment remained in the demented range, test performance improved.