RESUMEN
INTRODUCTION: Countering HIV infection remains a primary objective of the Spanish National Health System. Emergency services play a crucial role in reducing missed diagnostic opportunities, with estimates suggesting that one in 3 such opportunities occur here. The aim of the study is to examine the geographical dispersion of newly diagnosed HIV cases, within a downtown Madrid hospital. METHODS: This is an observational, descriptive, retrospective study evaluating the geographical distribution of new HIV diagnoses in the care area of a tertiary University Hospital in the Community of Madrid. RESULTS: Three hundred and eighty-seven individuals with a new diagnosis of HIV infection between 2018 and 2020 were analysed, the majority being young people with an average age of 36±9 years. 86% were gay, bisexual and other men who have sex with men and 48.6% were immigrants. 15.3% presented with CD4+<200cells/mm3 and 9.5% with an AIDS-defining illness. 32.7% and 5.1% had an RNA-HIV-1>100,000copies/mL and >500,000copies/mL, respectively, with up to 13.7% of subjects presenting resistance mutations at diagnosis. Geographically, 51.4% of individuals came from 4 Health Centres and more than 70% of the new diagnoses were included in nine Health Centres. CONCLUSION: Better understanding the geographical distribution of new HIV diagnoses by health areas allows us to identify areas of higher transmission risk, thereby directing and implementing prevention, early diagnosis, and treatment measures.
Asunto(s)
Infecciones por VIH , Minorías Sexuales y de Género , Masculino , Humanos , Adolescente , Adulto , Persona de Mediana Edad , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Homosexualidad Masculina , Estudios Retrospectivos , Centros de Atención Terciaria , Atención a la Salud , DemografíaAsunto(s)
Brotes de Enfermedades , Enfermedad de los Legionarios/diagnóstico , Anciano , Anciano de 80 o más Años , Antibacterianos/uso terapéutico , Femenino , Humanos , Legionella pneumophila/aislamiento & purificación , Enfermedad de los Legionarios/diagnóstico por imagen , Enfermedad de los Legionarios/tratamiento farmacológico , Enfermedad de los Legionarios/epidemiología , Pulmón/diagnóstico por imagen , Masculino , Persona de Mediana Edad , Radiografía , Estudios Retrospectivos , España/epidemiologíaAsunto(s)
Loiasis/diagnóstico , Adulto , Edema/etiología , Eosinofilia/etiología , Femenino , Humanos , Loiasis/complicaciones , Tejido Subcutáneo , Viaje , Medicina TropicalRESUMEN
Fever of unknown origin (FUO) has been rarely associated with colonic cancer. In less than 1% of cases of FUO a colonic cancer is found as the main cause of fever. The authors reviewed 4 cases of colonic cancer whose first manifestation was FUO. Recurrent episodes of brief, self-limited fever, without a characteristic pattern, may be the first symptom of colonic cancer. On occassions, E. coli bacteremia may be the herald of an occult colonic malignancy.
Asunto(s)
Neoplasias del Colon/complicaciones , Fiebre de Origen Desconocido/etiología , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , RecurrenciaAsunto(s)
Alopecia/inducido químicamente , Antivirales/efectos adversos , Citosina/efectos adversos , Organofosfonatos , Compuestos Organofosforados/efectos adversos , Infecciones Oportunistas Relacionadas con el SIDA/tratamiento farmacológico , Adulto , Cidofovir , Retinitis por Citomegalovirus/tratamiento farmacológico , Citosina/análogos & derivados , Humanos , MasculinoAsunto(s)
Antimaláricos/uso terapéutico , Malaria/prevención & control , Viaje , Cloroquina/uso terapéutico , Dapsona/uso terapéutico , Doxiciclina/uso terapéutico , Resistencia a Medicamentos , Quimioterapia Combinada , Humanos , Malaria/tratamiento farmacológico , Mefloquina/uso terapéutico , Proguanil/uso terapéutico , Pirimetamina/uso terapéuticoRESUMEN
Cerebral cysticercosis is an endemic parasitosis in many developing countries with a great variability in its presentation and prognosis. In the last 37 years (1960-1996) we have studied 18 patients at Fundación Jiménez Díaz. Sixteen were spanish; ten of them (62.5%) came from rural areas and they all were seen before 1988. Ten patients (56%) were males and seven (44%) females. The mean age was 49 years (range: 22-80). The most common symptoms at diagnosis were: seizures (61%), headache (55%), visual disturbances (39%), symptoms of intracranial hypertension (33%), mental disturbances (33%) and other focal symptoms (33%). CT and NMR showed changes in all cases, and hydrocephalia, presence of brain calcifications and ventricular or subarachnoidal parenchymal cysts were the most common findings. Three patients received antiparasitic therapy (praziquantel and albendazol), two of them associated with surgery. The most common surgical procedure was cyst exeresis and ventriculo-peritoneal shunts. The evolution was favorable in 90% of cases.
Asunto(s)
Encefalopatías/diagnóstico , Cisticercosis/diagnóstico , Adulto , Anciano , Anciano de 80 o más Años , Encefalopatías/etiología , Calcinosis/diagnóstico , Calcinosis/etiología , Cisticercosis/etiología , Femenino , Humanos , Imagen por Resonancia Magnética , Masculino , Persona de Mediana Edad , Convulsiones/etiología , Tomografía Computarizada por Rayos XRESUMEN
Cryptosporidiosis is a coccidian infection that usually occurs in children an immunocompromised patients. With the AIDS (Acquired Immunodeficiency Syndrome) epidemic there have been an increased number of clinical cases and still we don't have an optimal therapeutic regimen to eradicate the infection. Since 1907 when the organism was first described, a large amount of anti-infective agents have been used without success. We present herein a review of the new therapeutic approaches, although none of them is satisfactory and new studies are required for the development of an optimal treatment. Symptomatic and nutritional support are the unique treatment we have so far.
Asunto(s)
Coccidiostáticos/uso terapéutico , Criptosporidiosis/terapia , Adenina/análogos & derivados , Adenina/uso terapéutico , Amprolio/uso terapéutico , Animales , Azitromicina/uso terapéutico , Calostro/inmunología , Eflornitina/uso terapéutico , Humanos , Inmunoglobulinas , Espiramicina/uso terapéutico , Factor de Transferencia/uso terapéutico , Zidovudina/uso terapéuticoRESUMEN
Respiratory syncytial virus (RSV) usually affects children but sometimes affects a certain group of adults. A case of an 81 year old female with idiopathic thrombocytopenic purpura who had pneumonia caused by RSV is presented. The literature is reviewed as well as the most frequent clinical manifestations, diagnosis methods and treatment.