RESUMO
Diarrhea and wasting are among the most debilitating and deadly manifestations of AIDS, yet only limited information is available regarding the etiology, clinical consequences, and immunologic effects of infection with diarrheal agents. Peruvian AIDS patients presenting with and without diarrhea were followed prospectively to examine the relations among diarrheal pathogens, clinical presentations, CD4 lymphocyte count, weight loss, and survival. Patients with chronic diarrhea had lower CD4 lymphocyte counts (P = .001) and lost more weight (P < .001). Weight loss and a decreased CD4 lymphocyte count were associated with increased mortality (P = .011 and P = .003, respectively). Mean CD4 lymphocyte count varied significantly by diarrheal agent. Clostridium difficile was the most prevalent pathogen and was associated with significantly increased mortality before and after adjustment for coinfection, length of follow-up, CD4 lymphocyte count, and weight loss (P = .006). C. difficile may be a more important and more prevalent etiologic agent in AIDS than previously recognized and may represent a preventable cause of death in patients with immunosuppression.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Clostridioides difficile/isolamento & purificação , Diarreia/etiologia , Enterocolite Pseudomembranosa/microbiologia , Infecções Oportunistas Relacionadas com a AIDS/epidemiologia , Infecções Oportunistas Relacionadas com a AIDS/imunologia , Adulto , Contagem de Linfócito CD4 , Clostridioides difficile/imunologia , Infecção Hospitalar/microbiologia , Enterocolite Pseudomembranosa/epidemiologia , Enterocolite Pseudomembranosa/imunologia , Feminino , Humanos , América Latina/epidemiologia , Masculino , Estudos Prospectivos , Taxa de Sobrevida , Redução de PesoRESUMO
The male patient is in his fifth decade with a history of four months with right nasal obstruction, hematopurulent rhinorrea and scabs in the nose. The initial physical examination showed necrotic tissue and scabs in both the nasal foci. Three months later he presented a septal perforation and eroded necrotic injury in the hard palate. The two initial biopsies that were carried out showed chronic unspecified inflammation, and the third reported a polymorphic reticulosis. The histopathological analysis of the material of the third biopsy showed the existence of a non-angiocentric intermediate centrofacial lymphoma. The patient was submitted to treatment with simultaneous radiotherapy and chemotherapy with the end result of a totally successful remission of the lymphoma. These abnormalities usually appear as ulcers and erosions of the cartilage and bones of the nose, the paranasal sinuses and the palate. They are polymorphic, and there exists evidence of its association with the Ebstein Barr virus. The patient has been observed during the last five years and has shown no evidence of recurrence of any related of the disease. As a consequence of the sickness, the patient had difficulties to talk and eat, but with rehabilitation he now has adequate phonation and eating capacity. The immunohistochemistry and molecular genetic science branches of medicine have almost solved the diagnostic and therapeutic problems related to this sickness. The individual's prognosis depends mainly on the extension of the affection and seriousness of the disease from which the patient suffers.
Assuntos
Linfoma de Células T , Neoplasias Palatinas , Palato , Humanos , Linfoma de Células T/patologia , Linfoma de Células T/terapia , Masculino , Pessoa de Meia-Idade , Neoplasias Palatinas/patologia , Neoplasias Palatinas/terapiaRESUMO
Two cases of hemangiomas on the tongue treated by injection of sclerosants products (1% Aethoxysklerol), combined with reconstructive surgery, are reported. The efficacy of such treatment for hemangiomas located at that level is demonstrated.
Assuntos
Hemangioma Cavernoso/terapia , Hemangioma/terapia , Polietilenoglicóis/administração & dosagem , Soluções Esclerosantes/administração & dosagem , Escleroterapia/métodos , Neoplasias da Língua/terapia , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , PolidocanolRESUMO
We describe a simple, sensitive, and quantitative procedure for measurement of triglycerides and protein contents in formalin-fixed liver sections. The method can detect as little as 0.27 microgram of triglycerides per mg of protein. It is based on selective binding of Sudan IV and Fast Green FCF to fat and total proteins, respectively, and their sequential elution with solvents. Sudan IV is eluted readily with acetone and Fast Green with NaOH-methanol, and the absorbances obtained at 500 and 610 nm can be used to determine the amount of triglycerides and total protein. The color equivalence for Fast Green was obtained after destaining the sections and measuring the protein contents by micro-Kjeldahl analysis. The color equivalence of Sudan IV was estimated by determining the triglyceride content in liver homogenates by an enzymatic procedure and then measuring the amount of dye bound to multiple fixed sections. There was a strong linear correlation between the triglyceride content as determined chemically and that obtained using the equivalence colors (r2 = 0.98). This method is useful to measure fat content in tissue samples and could be applied to evaluate the progression of liver disease.