RESUMEN
The aim of this study was to define standard values for fat mass distribution by dual-energy X-ray absorptiometry in human immunodeficiency virus (HIV)-negative men and to analyze factors associated with lipodystrophy in HIV-infected men. Total-body composition was analyzed in 241 HIV-negative men (controls) and 162 HIV-infected men. We created a fat mass ratio (FMR) as the ratio of the percentage of the trunk fat mass to the percentage of the lower limbs fat mass. We defined the FMR standard values as the mean value+/-standard deviation. We compared body mass index (BMI), fat mass percentage (%FM), lean mass (LM), bone mineral density (BMD), and FMR between the control group and HIV-infected men, by age range, according to prescription of treatment and presence of clinical lipodystrophy. The FMR standard value is equal to 1.3+/-0.2. The FMR was higher in treated HIV-infected men with or without clinical lipodystrophy. The FMR was similar for naïve HIV-infected men and controls. It was positively correlated with age, cumulative time on treatment, zidovudine, stavudine, or indinavir. BMD and fat mass were lower for treated and naïve HIV-infected men than for HIV-negative men. The FMR seems to be a valuable index for measuring fat mass distribution. We defined FMR standard values from the largest group of HIV-negative men to our knowledge. Applying FMR to HIV patients could help physicians to diagnose lipodystrophy earlier.
Asunto(s)
Absorciometría de Fotón , Composición Corporal , Anticuerpos Anti-VIH/inmunología , Síndrome de Lipodistrofia Asociada a VIH/diagnóstico , VIH/inmunología , Adulto , Densidad Ósea , Estudios Transversales , Síndrome de Lipodistrofia Asociada a VIH/virología , Humanos , Masculino , Persona de Mediana EdadRESUMEN
PCR and culturing were compared for the routine diagnosis of Chlamydia trachomatis infections. Two laboratories experienced in both techniques participated in the study, which included 513 specimens. Both techniques were performed on each specimen; the portion of the specimen used for PCR was divided in two, and each half was sent to one of the two laboratories, where the tests were run in a blinded fashion. The PCR primers used by the two laboratories matched different parts of the bacterial genome. PCR inhibitors were looked for in all specimens. Overall, PCR was more sensitive than culturing; the difference was marked for sperm and endopelvic specimens and nonsignificant for urethral and cervical specimens. False-positive PCR results were few in number; there were no consistent false-positive results when each specimen was amplified twice. PCR inhibitors were rarely present in urethral and cervical specimens but were found in 7% of sperm and endopelvic specimens. PCR inhibitors should be looked for routinely during PCR testing of sperm or endopelvic specimens.
Asunto(s)
Técnicas Bacteriológicas , Infecciones por Chlamydia/diagnóstico , Chlamydia trachomatis/aislamiento & purificación , Enfermedades de los Genitales Femeninos/diagnóstico , Enfermedades de los Genitales Masculinos/diagnóstico , Reacción en Cadena de la Polimerasa , Moco del Cuello Uterino/microbiología , Chlamydia trachomatis/genética , Chlamydia trachomatis/crecimiento & desarrollo , Reacciones Falso Positivas , Femenino , Enfermedades de los Genitales Femeninos/microbiología , Enfermedades de los Genitales Masculinos/microbiología , Humanos , Masculino , Enfermedad Inflamatoria Pélvica/diagnóstico , Enfermedad Inflamatoria Pélvica/microbiología , Semen/microbiología , Sensibilidad y Especificidad , Método Simple Ciego , Uretritis/diagnóstico , Uretritis/microbiología , Cervicitis Uterina/diagnóstico , Cervicitis Uterina/microbiologíaRESUMEN
Knowledge of the pathophysiological mechanisms governing Parvovirus B19 infection has been modified with the recent discovery of its cellular receptor. The cell lines susceptible to infection can be identified on the basis of the nature and distribution of the virus in the human organism. The Parvovirus B19 can undergo two types of cycles within the host cell. The first is a complete cycle within the infected cell leading to cell death by lysis. In the second, the cycle aborts and cell death is caused by an association of immunological phenomena and the accumulation of viral proteins toxic to the cell. It is not known why complete cycles are restricted to a single erythrocyte line. These new data not only give a more precise explanation of the classical clinical expression of the disease, but also suggest possible mechanisms for the pathogenic power of the Parvovirus B19, some of which have already been proposed on the basis of clinical observations.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/fisiopatología , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Artritis/etiología , Eritema Infeccioso/fisiopatología , Parvovirus B19 Humano/aislamiento & purificación , Púrpura/etiología , Aplasia Pura de Células Rojas/etiología , Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Infecciones Oportunistas Relacionadas con el SIDA/virología , Eritema Infeccioso/complicaciones , Eritema Infeccioso/virología , Femenino , Humanos , Masculino , Parvovirus B19 Humano/patogenicidad , Embarazo , VirulenciaRESUMEN
Salmonella kedougou BM2659 was isolated from the stools and a blood culture of a patient and Klebsiella pneumoniae BM2657 and S. kedougou BM2658 were isolated later from the stools of the same patient. Strains BM2657 and BM2658 had identical resistance phenotypes, to beta-lactams, aminoglycosides and tetracycline, due to the presence of the same genes, blaT, aacA4 and tetC, respectively. Oligotyping indicating that beta-lactam resistance in these strains was encoded by blaT-3 and synthesis of TEM-3 was confirmed by isoelectric focusing. In BM2657 and BM2658, the resistance characters were located on Inc7 or M self-transferable plasmids with indistinguishable EcoRI and HindIII restriction patterns. Southern hybridization of plasmid DNA of these strains with probes pCFFO4, the prototype plasmid encoding TEM-3, genes blaT, aacA4 and tetC gave identical patterns. S. kedougou BM2658 and BM2659 had identical biotypes and serotypes but BM2659 was susceptible to all the study antibiotics. These observations suggest possible transfer, in the digestive tract, of a plasmid encoding TEM-3 beta-lactamase from K. pneumoniae BM2657 to S. kedougou BM2659.
Asunto(s)
Klebsiella pneumoniae/enzimología , Salmonella/enzimología , beta-Lactamasas/genética , Antibacterianos/farmacología , Conjugación Genética , Medios de Cultivo , ADN Bacteriano/análisis , ADN Bacteriano/aislamiento & purificación , Sistema Digestivo/microbiología , Farmacorresistencia Microbiana/genética , Electroforesis en Gel de Poliacrilamida , Focalización Isoeléctrica , Klebsiella pneumoniae/genética , Pruebas de Sensibilidad Microbiana , Hibridación de Ácido Nucleico , Fenotipo , Plásmidos , Salmonella/genética , Transfección , beta-Lactamasas/biosíntesisRESUMEN
Bactericidal activity of gentamicin, imipenem, ciprofloxacin and cefotaxime associated with sulbactam are studied on 36 beta lactamase CTX-1 (TEM-3) producing Klebsiella pneumoniae strains isolated of sputum samples and urines, among patients of intensive care units, in Rangueil hospital (Toulouse). Gentamicin, imipenem, cefotaxime associated with sulbactam have a bactericidal activity at serum levels, obtained with usual therapeutic doses. Ciprofloxacin has a bactericidal activity at concentrations obtained in urine and into lung tissue. Killing curve method was used to study bactericidal activity of these antibiotics alone and in combination, on a representative sample. Alone gentamicin showed the most rapid bactericidal activity (2 hours). The associations with gentamicin are also rapidly bactericidal. The associations with ciprofloxacin and imipenem, ciprofloxacin and cefotaxime/sulbactam are synergistic.