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Fémur , Inmunocompetencia , Tuberculosis Osteoarticular/diagnóstico , Adulto , Humanos , Masculino , DolorRESUMEN
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Masculino , Adulto , Humanos , Fémur , Inmunocompetencia , Tuberculosis Osteoarticular/diagnóstico , DolorRESUMEN
OBJECTIVE: To measure CD4 molecule concentration on lymphocyte surface. And observe its evolution during one year, in HIV infected patients. To assess the importance of this measure as a prognostic marker for disease progression, compared with the total number of CD4 lymphocytes. METHODS: Clinical and analytical data from 107 patients were collected; 64 fulfilled a one-year follow-up. 45 were initially asymptomatic (ASN), 13 had AIDS-related complex (CRS) and 6 had AIDS. CD4 cell count was higher than 500 in 16, between 500 and 200 in 20, and lower than 200 in 28. CD4 molecule concentration in lymphocytes was measured with immunoassay capcellia CD4/CD8 (Pasteur Institute, Paris). During one year 12 patients progressed cunically. RESULTS: There was significant decrease of T4 lymphocytes in the following groups whole population, CRS, more than 500 (initially). There were significant decreases of CD4 molecules in the following groups: whole population, ASN, CRS, more than 500 (initially), between 500 and 200 (initially), the mean number of T4 lymphocytes was 140/mm3 in progressors versus 358 in non-progressors (p < 0.05). Initial CD4 molecule concentration was 3.87 pmol/l in progressors versus 11.50 pmol/l in non-progressors (p < 0.05). CONCLUSIONS: Both total number of T4 lymphocytes and CD4 molecule concentration decrease with time. However, in asymptomatic patients only CD4 molecule decrease reaches statistical signification. Both T4 lymphocyte number and CD4 molecule concentration were lower in progressors. Measurement of CD4 molecule concentration is a parameter of similar value with respect to T4 lymphocyte count, and with similar value as progression marker.
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Antígenos CD4/sangre , Infecciones por VIH/sangre , Adulto , Recuento de Linfocito CD4 , Linfocitos T CD4-Positivos , Femenino , Humanos , Masculino , Pronóstico , Estudios ProspectivosAsunto(s)
Encefalopatías/complicaciones , Calcinosis/complicaciones , Enfermedad Celíaca/complicaciones , Enfermedad Celíaca/fisiopatología , Epilepsia/etiología , Epilepsia/fisiopatología , Adolescente , Edad de Inicio , Encefalopatías/diagnóstico , Encefalopatías/fisiopatología , Calcinosis/diagnóstico , Calcinosis/patología , Enfermedad Celíaca/diagnóstico , Electroencefalografía , Epilepsia/diagnóstico , Femenino , Humanos , Tomografía Computarizada por Rayos XRESUMEN
BACKGROUND: The present study was performed to analyze the evolution of the incidence of tuberculosis in La Rioja (Spain) from January 1988 to March 1993. The influence of factors such as HIV infection and alcoholism was analyzed. The sensitivity of the bacilloscopy in the diagnosis was studied. METHODS: The cases were collected from the Regional Tuberculosis Program of the Public Health Department in La Rioja, with clinical histories being collected from the Internal Medicine Department of the Hospital San Millán in Logroño. Cases of tuberculosis were microbiologically confirmed by cultures of Mycobacterium tuberculosis. RESULTS: The total number of cases studied was 649 with the incidence of tuberculosis in La Rioja being 51 cases/100,000 inhabitants in 1992. The mean age of all the patients was 45 years with 80% of the tuberculosis being pulmonary and 20% extrapulmonary. Twelve percent of the patients were HIV+; 18% being extrapulmonary tuberculosis and 10.8% pulmonary tuberculosis, p < 0.02. Pleural and urogenital tuberculosis were present in fewer HIV+ patients. Bacilloscopy was negative requiring a culture for diagnosis in 28.6% of the cases with this circumstance more frequently occurring in the pleural and urogenital forms of the diseases. Treatment has evolved from the use of ethambutol in the first few years to the present use of pyrazinamide. CONCLUSIONS: No trend towards an increase in the incidence of tuberculosis in the time period studied was observed in La Rioja. Extrapulmonary tuberculosis was the type of tuberculosis most frequently found in HIV positive patients, with pleural and urogenital forms of the disease being less frequently found in these patients. In these case the bacilloscopy was also found to be negative more frequently.
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Infecciones por VIH/complicaciones , Tuberculosis/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , España/epidemiología , Tuberculosis/complicaciones , Tuberculosis/diagnóstico , Tuberculosis/microbiologíaRESUMEN
We present two cases of infection by Coxiella burnetii which developed with sustained fever symptoms. During its evolution, the first case presented granulomatous hepatitis, whereas the second case presented left Cosofemoral Arthritis. We describe the clinical-evolutive characteristics of these clinical forms and within the evolution of the chronic forms of Q fever.
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Hepatitis/microbiología , Osteoartritis de la Cadera/microbiología , Fiebre Q/diagnóstico , Adulto , Humanos , MasculinoAsunto(s)
Infarto Cerebral/etiología , Endocarditis/etiología , Inhibidor de Coagulación del Lupus/sangre , Lupus Eritematoso Sistémico/complicaciones , Lupus Eritematoso Sistémico/etiología , Adulto , Infarto Cerebral/sangre , Endocarditis/sangre , Femenino , Humanos , Lupus Eritematoso Sistémico/sangreRESUMEN
Fifty cases of brucellosis attending our Service of Internal Medicine during the period 1985-1990 are restrospectively studies. The number of patients in which the potential transmission mechanism and the risk factor involved are unknown is very high, being the percentage higher among women from urban areas (50%). Thus, greater attention should be paid to transmission sources considered unfrequent and to survival of the germ in several biological environments, as well as to consumption of non-pasteurized dairy products. The evolution period of the disease until hospitalization and diagnosis is large (48.6 days), especially in its oligosymptomatic forms. The diagnostic method is based mainly in clinical observations plus agglutinations, with positive hemocultive as the diagnostic method in just 6% of the cases. Treatment with streptomycin and tetracycline is still highly effective.