RESUMEN
The sedimentary record in the Guadix-Baza Basin (southern Spain) has proved to be a great source of information for the Miocene through the Pleistocene periods, due to the abundant faunal remains preserved, in some cases associated with lithic tools. The Solana del Zamborino (SZ) section has been the subject of controversy ever since a magnetostratigraphic analysis resulted in an age of 750-770 Kyr for Acheulean tools, a chronology significantly older than the ~600 Kyr established chronology for the first Acheulean record in Europe. Although recent findings at the "Barranc de la Boella" site (north-east of the Iberian Peninsula) seem to indicate that an earlier introduction of such technique in Europe around 0.96-0.781 Ma is possible, the precise age of the classical site at SZ is still controversial. The aim of this paper is to constrain the chronology of the site by developing a longer magnetostratigraphic record. For this purpose, we carried out an exhaustive sampling in a new succession at SZ. Our results provide a ~65 m magnetostratigraphic record in which 4 magnetozones of normal polarity are found. Our new magnetostratigraphic data suggest an age range between 300-480 Kyr for the lithic tools, closer to the age of traditional Acheulean sites in Europe.
Asunto(s)
Antropología/métodos , Hominidae/fisiología , Comportamiento del Uso de la Herramienta , Animales , Biodiversidad , Sedimentos Geológicos/química , Hominidae/anatomía & histología , Fenómenos Magnéticos , EspañaRESUMEN
OBJECTIVE: To study the predictive value of anti-Toxoplasma gondii antibody titres for the occurrence of toxoplasmic encephalitis (TE) in HIV-infected patients. METHODS: Data from the placebo arm of a trial of primary prophylaxis for TE (ANRS 005/ACTG 154) were analysed. Patients included had CD4+ cell counts < 200 x 10(6)/l and a positive Toxoplasma serology. Immunoglobulin (Ig) G and IgM Toxoplasma antibody titres at entry were retrospectively determined by enzyme-linked immunosorbent assay and agglutination on serum samples in a single laboratory. Incidence of TE was estimated by Kaplan-Meier method and a Cox model was used to study the predictive value of antibody titres, adjusted for other covariates. RESULTS: All 164 patients studied were positive for IgG antibodies and one had IgM antibodies. After a mean follow-up of 16 months, 31 cases of TE were documented. One-year incidence of TE was significantly higher in patients with IgG titres > or = 150 IU/ml (23.7%) than in patients with titres < 150 IU/ml (7.7%; relative risk, 3.1; P < 0.003). IgG titres remained significantly associated with the occurrence of TE (relative risk, 3.3; P < 0.005) in the Cox model. Predictive value of IgG titres did not differ according to baseline CD4+ cell counts. CONCLUSIONS: In patients with CD4+ cell counts < 200 x 10(6)/l, IgG anti-Toxoplasma antibody titre is a prognostic factor of occurrence of TE, with a higher risk for titres > or = 150 IU/ml. This finding should reinforce the recommendation of specific prophylaxis in these patients.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/inmunología , Anticuerpos Antiprotozoarios/sangre , Encefalitis/inmunología , Toxoplasma/inmunología , Toxoplasmosis Cerebral/inmunología , Infecciones Oportunistas Relacionadas con el SIDA/sangre , Adolescente , Adulto , Animales , Antiprotozoarios/uso terapéutico , Recuento de Linfocito CD4 , Método Doble Ciego , Encefalitis/sangre , Encefalitis/tratamiento farmacológico , Femenino , Estudios de Seguimiento , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Valor Predictivo de las Pruebas , Probabilidad , Pirimetamina/uso terapéutico , Ensayos Clínicos Controlados Aleatorios como Asunto , Estudios Retrospectivos , Toxoplasmosis Cerebral/sangre , Toxoplasmosis Cerebral/tratamiento farmacológicoRESUMEN
Human papillomavirus genomic types present in human warts of an Argentine population were studied. HPV DNA from single warts was obtained using an alkaline extraction procedure that resulted in a clean DNA preparation, which could be analyzed with several endonucleases. This method was used to isolate and insert the HPV DNAs of two genomic types into the Bam HI site of the pBR322 plasmid. Restriction maps of both HPV DNAs were constructed. According to these maps, one of the genomic variations was identical to HPV1a and the other to HPV2a. The incidence of HPV2 and of HPV1 in different types of skin warts was studied by a dot blot hybridization assay. Twenty-two out of 28 common warts were positive for HPV2 and negative for HPV1; four were positive for HPV1 and negative for HPV2 and two were negative for both. Five out of six plantar warts were positive for HPV1, and one was negative for both. Three out of seven filiform warts were positive for HPV2, three were positive for both probes, and one was negative for both. Southern blot analysis of HPV2 positive samples indicated that 80% were HPV2a and 20% another subtype not yet characterized. All plantar warts contained HPV1a. Msp I/Hpa II restriction analysis confirms previous results indicating that HPV1a DNA is partially methylated, while no evidence of methylation was found for HPV2a DNA.
Asunto(s)
Papillomaviridae/aislamiento & purificación , Verrugas/microbiología , Argentina , Southern Blotting , Clonación Molecular , ADN Viral/genética , ADN Viral/aislamiento & purificación , Escherichia coli/genética , Humanos , Hibridación de Ácido Nucleico , Papillomaviridae/genética , Verrugas/epidemiologíaRESUMEN
To improve the epidemiological study of suicide and attempted suicides in Aquitaine, France, we developed a comprehensive surveillance system based on the input of Sentinel General Practitioners (SGPs). From October 1986 to May 1988, for each case of suicide or attempted suicide, the SGPs reported epidemiological data to our system through a computer network of personal home terminals (Minitels). Data included age, sex, method and result of attempt and antecedents. In an analysis of the relationship between the suicidal method, antecedents and results of suicidal act, the principal findings were a high rate of antecedents of suicide attempts by drug overdoses, hangings and drownings; and no antecedents for attempts by the use of firearms. This may show that the increasing accessibility of firearms is making it more likely that impulsive suicide attempts will be lethal.
Asunto(s)
Redes de Comunicación de Computadores , Sistemas de Computación , Suicidio/estadística & datos numéricos , Adulto , Femenino , Francia/epidemiología , Humanos , Masculino , Microcomputadores , Intento de Suicidio/estadística & datos numéricosRESUMEN
Nine patients with recurrent and long lasting common warts were treated with intralesional Hu-IFN-alpha. The schedule was a single dose per wart, ranged between 10(5) and 2 x 10(5) IU. Placebo was also administered in 3 of these patients. Complete remission was observed in 7 of the 9 patients. The pattern of warts involution and the possible interferon mechanism of action are discussed. A significant pain relief, produced by interferon injection was observed in the patients with plantar warts and in one patient with subungueal wart.
Asunto(s)
Interferón Tipo I/administración & dosificación , Verrugas/terapia , Adolescente , Adulto , Niño , Femenino , Humanos , Inyecciones Intralesiones , Interferón Tipo I/efectos adversos , Interferón Tipo I/uso terapéutico , Masculino , RecurrenciaRESUMEN
To identify risk factors for cerebral toxoplasmosis (CT) in HIV patients (pts) with positive serology for Toxoplasma gondii and CD4 < 200/mm3, data from the placebo group (N = 280) of a primary prophylaxis trial, were analyzed. The probability of onset of CT (n = 46) was, at one year, 13.1%. Three baseline variables were independently associated with a higher risk of CT: group IV non AIDS, AIDS stage and CD4 < 50/mm3. Initial titer of antibodies to Toxoplasma gondii was not.
Asunto(s)
Infecciones por VIH/complicaciones , VIH-1 , Pirimetamina/uso terapéutico , Toxoplasmosis Cerebral/prevención & control , Método Doble Ciego , Humanos , Factores de Riesgo , Toxoplasmosis Cerebral/etiologíaRESUMEN
A multi-institutional double blind study was performed in 66 patients in order to evaluate the action of human leukocyte interferon, type alpha (IFN) in lesions produced by herpes simplex virus. Lesions were localized in genital area in 34 cases and in facial area in 32 of them. From the total, 38 patients were treated with 7,000 Ul/gm. of interferon ointment and 28 with carbowax 4,000 as placebo. The symptoms pain, ardor, itching and paresthesia were evaluated asking to patients. Erythema, vesicles, crust, scale adenopathy were objectivated. Signs and symptoms were controlled on days 3 and 7 of treatment. In 42 patients, lesions specimens were taken for virus isolation. In 23 of them, cytopathic effect was detected (54.76%). Results showed a rapid relief from pain (p less than 0.05), ardor (p less than 0.01) and paresthesia (p less than 0.001) and also accelerated healing of vesicles in patients treated with interferon. Tendency to reduce the total time of the disease in those patients treated with IFN was observed.
Asunto(s)
Herpes Simple/terapia , Interferón Tipo I/uso terapéutico , Administración Tópica , Adolescente , Adulto , Anciano , Argentina , Niño , Preescolar , Método Doble Ciego , Evaluación de Medicamentos , Femenino , Humanos , Lactante , Interferón Tipo I/administración & dosificación , Masculino , Persona de Mediana Edad , Estudios Multicéntricos como Asunto , PomadasRESUMEN
Introducción: La sialolitiasis parotídea es una patología común de las glándulas salivales y puede dar lugar a atrofia glandular. Los sialolitos parotídeos son más raros que los submandibulares y su diagnóstico y tratamiento es más complejo, debido a la superposición de estructuras y a las dificultades de acceso. Caso clínico: Mujer, de 68 años, que acude con episodios inflamatorios recurrentes en la región geniana izquierda, coincidente con las comidas, y que, tras su paso por varios especialistas, acude a nuestro Servicio, en el que tras prescribir un CBCT con reconstrucción tridimensional se halla una pequeña estructura calcificada próxima a la parótida izquierda. Discusión: Los métodos de diagnóstico son variados y su utilización depende de la indicación. Entre las distintas pruebas figuran la resonancia magnética (RM), laa Tomografía Computerizada de Haz de Cono (CBCT) y la sialografía, siendo el método más eficaz de diagnóstico la combinación de estas. Los abordajes terapéuticos son diversos y dependen de multitud de factores, siendo los más utilizados la sialoendoscopia y el abordaje quirúrgico transoral. Conclusión: La sialolitiasis parotídea supone un reto, tanto diagnóstico como terapéutico, y es una situación clínica común por lo que en su tratamiento deben tenerse en cuenta muchos factores para elegir la alternativa que suponga una remoción completa del cálculo y pocas complicaciones a largo plazo
Introduction: Parotid stones are a common finding in salivary gland disorders and can lead to destruction of salivary tissue. Parotid calculi are rarer than submandibular calculi and their diagnosis and treatment are more challenging due to superimposition of hard structures and limited access. Clinical case: A female patient, 68 years old, is referred to our Service, after seeing different specialists, due to repeated inflammatory episodes of her left cheek area, which usually appear at mealtimes. After prescribing a CBCT with 3D reconstruction, a calcified structure can be seen next to the left parotid gland. Discussion: Diagnostic means are varied, and their use depends on their indication. Among diagnostic test, MRI, CBCT and sialography can be found, and usually combining them provides a more precise diagnosis. There are many therapeutical approaches, being sialoendoscopy and transoral approach the most common ones. Conclusion: Parotid sialolithiasis poses a diagnostic and therapeutic challenge, and it is a relatively common clinical situation, thus, treatment must be tailored to obtain complete stone removal and a minimum of long-term complications
Asunto(s)
Humanos , Femenino , Anciano , Cálculos de las Glándulas Salivales/diagnóstico por imagen , Cálculos de las Glándulas Salivales/cirugía , Cálculos de las Glándulas Salivales/complicaciones , Cálculos de las Glándulas Salivales/fisiopatología , Glándula Parótida/patologíaRESUMEN
We described the baseline polymorphism of the human immunodeficiency virus type 2 (HIV-2) protease gene from 94 treatment-naive patients and the longitudinal follow-up of 17 protease inhibitor-treated patients. Compared to the HIV-2 consensus sequences, baseline polymorphism involved 47 positions. Substitutions selected under treatment were observed at positions corresponding to HIV-1 resistance mutations as well as at positions of currently unknown impact on HIV-1.
Asunto(s)
Proteasa del VIH/genética , Mutación , Polimorfismo Genético , Adulto , Farmacorresistencia Viral/genética , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/virología , Inhibidores de la Proteasa del VIH/farmacología , Inhibidores de la Proteasa del VIH/uso terapéutico , VIH-2/efectos de los fármacos , VIH-2/enzimología , VIH-2/genética , Humanos , MasculinoRESUMEN
The authors inquire if in an educational process and a change in the management for the central venous catheters, have any effect in the decrease of the catheter-related infection (CRI). The strategy consist on doing a new protocol and its communication to the professional people twice per year. A population descriptive analysis is done with medians and description of the etiology. The percentages of CRI are compared between controls periods of one year and intervention periods of one year as well, using association measurements. A total number of 31 CRI's were diagnosed, 19 in the control process and 12 in the intervention process with a results of 8.17 and 4.29 per thousand days of central venous catheter (OR = 0.52; IC = 95%, 0.25 -1.03). In no case was death related with the CRI. The new strategy of handling the central veins access, based on the implications of the assistant staff, reduce the risk of CRI
Asunto(s)
Infecciones Bacterianas/prevención & control , Cateterismo Venoso Central/efectos adversos , Cateterismo Venoso Central/enfermería , Contaminación de Equipos , Control de Infecciones , APACHE , Bacteriemia/prevención & control , Femenino , Humanos , Unidades de Cuidados Intensivos , Masculino , Persona de Mediana Edad , Factores de TiempoRESUMEN
In order to define more accurately human immunodeficiency virus-infected patients at risk of developing toxoplasmic encephalitis (TE), we assessed the prognostic significance of the anti-Toxoplasma gondii immunoglobulin G (IgG) immunoblot profile, in addition to AIDS stage, a CD4(+) cell count <50/mm(3), and an antibody titer > or =150 IU/ml, in patients with CD4 cell counts <200/mm(3) and seropositive for T. gondii. Baseline serum samples from 152 patients included in the placebo arm of the ANRS 005-ACTG 154 trial (pyrimethamine versus placebo) were used. The IgG immunoblot profile was determined using a Toxoplasma lysate and read using the Kodak Digital Science 1D image analysis software. Mean follow-up was 15.1 months, and the 1-year incidence of TE was 15.9%. The cumulative probability of TE varied according to the type and number of anti-T. gondii IgG bands and reached 65% at 12 months for patients with IgG bands of 25 and 22 kDa. In a Cox model adjusted for age, gender, Centers for Disease Control and Prevention (CDC) clinical stage, and CD4 and CD8 cell counts, the incidence of TE was higher when the IgG 22-kDa band (hazard ratio [HR] = 5.4; P < 0.001), the IgG 25-kDa band (HR = 4.7; P < 0.001), or the IgG 69-kDa band (HR = 3.4; P < 0.001) was present and was higher for patients at CDC stage C (HR = 4.9; P < 0.001). T. gondii antibody titer and CD4 cell count were not predictive of TE. Thus, detection of IgG bands of 25, 22, and/or 69 kDa may be helpful for deciding when primary prophylaxis for TE should be started or discontinued, especially in the era of highly active antiretroviral therapy.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/inmunología , Toxoplasma/inmunología , Toxoplasmosis Cerebral/inmunología , Infecciones Oportunistas Relacionadas con el SIDA/diagnóstico , Animales , Antígenos de Protozoos/inmunología , Método Doble Ciego , Humanos , Immunoblotting , Valor Predictivo de las Pruebas , Sensibilidad y Especificidad , Toxoplasmosis Cerebral/diagnósticoRESUMEN
Although drug-induced rash is frequent in human immunodeficiency virus (HIV)-infected patients, rash due to pyrimethamine has not been described previously. In a randomized, double-blind, placebo-controlled study of pyrimethamine as primary prophylaxis for toxoplasmic encephalitis, the incidence of rash (per hundred patient-years) was 8.1 in the pyrimethamine group versus 1.5 in the placebo group (P < .0002). The 1-year incidence of toxoplasmic encephalitis after occurrence of rash was 37%, as compared with 9.6% in the pyrimethamine group without rash, with a 3.7 times higher risk for patients with pyrimethamine-induced rash (P = .001); the incidence was 13% in the placebo group. At the time of toxoplasmic encephalitis, pyrimethamine was successfully readministered to 80% of patients who discontinued it because of rash. Thus, pyrimethamine, when used for prophylaxis, does induce rash in HIV-infected patients. These patients are at higher risk for toxoplasmic encephalitis and should be carefully monitored for it.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/prevención & control , Antiprotozoarios/efectos adversos , Erupciones por Medicamentos/etiología , Pirimetamina/efectos adversos , Toxoplasmosis Cerebral/prevención & control , Progresión de la Enfermedad , Método Doble Ciego , Encefalitis/prevención & control , Infecciones por VIH/fisiopatología , Humanos , Factores de RiesgoRESUMEN
Among sexually transmitted diseases, infection by human papillomavirus (HPV) has become one of the most important. On the other hand, though epidemiological data show that some HPV types are closely associated with cervical cancer, few reports have been found with reference to penile carcinoma because of its rare occurrence. The aim of this study was to investigate the relationship between HPV infection and penile cancer in Argentina. A retrospective study was carried out on 38 white men with penile squamous-cell carcinoma. Sixty-five archival fixed biopsies taken from 34 primary penile tumors, 25 nodal metastases, 1 skin "satellite" metastasis and 5 histologically normal lymph nodes were used as specimens. HPV detection and typing were carried out by the polymerase chain reaction (PCR) using generic primers, combined with single-stranded conformational polymorphism (SSCP) analysis. HPV DNA was found in 71% patients, corresponding 81% of them to "high risk" types, with predominance of HPV 18. Both primary tumors and metastases showed concordance of HPV occurrence and type in both lesions. In 3 patients, HPV 16 was detected not only in primary tumors and metastases, but also in histologically normal lymph nodes. Our data indicate that most penile carcinomas in Argentine patients are etiologically related to HPV, especially to "high risk" genital types. The agreement in HPV detection between primary tumors and metastases suggests a potential viral role in tumor progression. HPV detection in otherwise histologically normal lymph nodes might be useful as early marker of a metastatic process.
Asunto(s)
Carcinoma de Células Escamosas/virología , Papillomaviridae , Neoplasias del Pene/virología , Adulto , Anciano , Argentina/epidemiología , Carcinoma de Células Escamosas/epidemiología , Carcinoma de Células Escamosas/secundario , ADN Viral/análisis , Humanos , Ganglios Linfáticos/virología , Metástasis Linfática , Masculino , Persona de Mediana Edad , Papillomaviridae/genética , Neoplasias del Pene/epidemiología , Neoplasias del Pene/secundario , Reacción en Cadena de la Polimerasa , Polimorfismo Conformacional Retorcido-Simple , Estudios Retrospectivos , Neoplasias Cutáneas/epidemiología , Neoplasias Cutáneas/secundario , Neoplasias Cutáneas/virologíaRESUMEN
Pyrimethamine (50 mg) with folinic acid (15 mg) given three times weekly was assessed as primary prophylaxis for toxoplasmic encephalitis (TE) in 554 human immunodeficiency virus-infected patients seropositive for Toxoplasma gondii and with < 200 CD4 cells/mm3. At 1 year, the incidence of TE was similar in pyrimethamine, 12%, and placebo, 13%, groups (relative risk [RR], 0.9; 95% confidence interval [CI], 0.6-1.4), and the survival rate was also similar, 85% and 80%, respectively (RR, 0.9; 95% CI, 0.7-1.2). Rash was the only adverse event that appeared significantly more frequently in the pyrimethamine arm (7% vs. 1%). In the on-treatment analysis, the incidence of TE was lower in the pyrimethamine arm, 4%, than in the placebo arm, 12% (P < .006). Thus, pyrimethamine cannot be recommended as a first-line regimen for primary prophylaxis of TE if the patient can take cotrimoxazole. However, it should be considered for patients who are intolerant to cotrimoxazole, especially in high-risk patients with < 100 CD4 cells/mm3.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/prevención & control , Antiinfecciosos/uso terapéutico , Encefalitis/prevención & control , Leucovorina/uso terapéutico , Pirimetamina/uso terapéutico , Toxoplasmosis Cerebral/prevención & control , Infecciones Oportunistas Relacionadas con el SIDA/mortalidad , Adulto , Animales , Antiinfecciosos/efectos adversos , Anticuerpos Antiprotozoarios/análisis , Método Doble Ciego , Quimioterapia Combinada , Encefalitis/mortalidad , Femenino , Estudios de Seguimiento , Humanos , Leucovorina/efectos adversos , Masculino , Análisis Multivariante , Pirimetamina/efectos adversos , Tasa de Supervivencia , Toxoplasma/inmunología , Toxoplasmosis/complicaciones , Toxoplasmosis Cerebral/mortalidadRESUMEN
The objective of this study was to assess whether patients with CD4+ cell counts <200 x 10(6)/L have a decreased survival after the occurrence of any AIDS-defining event; 187 patients from the placebo arm of a clinical trial of toxoplasmosis prophylaxis (ANRS005-ACTG154) were included. For this analysis, patients were HIV infected without any AIDS-defining event, had a CD4+ lymphocyte count < 200 x 10(6)/L, had a positive serology for Toxoplasma gondii, and had no severe liver, renal, or hematologic abnormalities. We used proportional hazards regression to study the relationships between baseline variables. AIDS-defining events as time-dependent variables, and survival. The risk of dying was increased by 1.9 for a 10-year increase in age and by 1.3 when CD4+ decreased by 50 x 10(6)/L; after the occurrence of a pneumocystosis, a cytomegalovirus infection, or a toxoplasmosis, the risk of dying was multiplied, respectively, by 10.9 (3.0-40.2), 10.0 (2.8-35.4), and 10.0 (4.5-22.2). None of the other AIDS-defining events was associated with an increased risk of dying, but the power to detect such an association was limited. We conclude that the occurrence of pneumocystosis, cytomegalovirus infection, or toxoplasmosis; age; and CD4+ cell count are important determinants of survival for HIV1-infected patients with CD4+ counts < 200 x 10(6)/L who are toxoplasmosis antibody positive.
Asunto(s)
Infecciones Oportunistas Relacionadas con el SIDA/mortalidad , Síndrome de Inmunodeficiencia Adquirida/mortalidad , Anticuerpos Antiprotozoarios/sangre , Recuento de Linfocito CD4 , Toxoplasma/inmunología , Infecciones Oportunistas Relacionadas con el SIDA/complicaciones , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Síndrome de Inmunodeficiencia Adquirida/inmunología , Adulto , Factores de Edad , Anciano , Animales , Intervalos de Confianza , Infecciones por Citomegalovirus/complicaciones , Infecciones por Citomegalovirus/mortalidad , Femenino , Síndrome de Emaciación por VIH/complicaciones , Síndrome de Emaciación por VIH/mortalidad , Humanos , Masculino , Persona de Mediana Edad , Neumonía por Pneumocystis/complicaciones , Neumonía por Pneumocystis/mortalidad , Modelos de Riesgos Proporcionales , Factores de Riesgo , Análisis de Supervivencia , Factores de Tiempo , Toxoplasmosis Cerebral/complicaciones , Toxoplasmosis Cerebral/mortalidadRESUMEN
In a single institution, we have used recombinant interferon- (IFN-) to treat 116 newly diagnosed Philadelphia-positive (Ph+) chronic myeloid leukemia (CML) patients and analyzed the predictive factors for response and survival. The patients whose median age was 50.3 years (range, 9 to 70) were administered IFN- (5 million units/m2/d) subcutaneously. The IFN- dose was subsequently adjusted to maintain the white blood cell and platelet counts between 1.5 and 5 x 10(9)/L, 50 and 100 x 10(9)/L, respectively. At diagnosis, the Sokal score was used to classify the patients into three groups: low (n = 57), intermediate (n = 42), and high risk (n = 16). A complete hematological response (CHR) was achieved in 93 cases (80.2%). Of the 116 patients, 113 were available for cytogenetic evaluation. Fifty patients (43%) achieved a major cytogenetic response (MCR) (=65% marrow Ph- cells), 37 of them having a complete cytogenetic response (CCR). The estimated 5-year survival of the 116 patients was 68% +/- 11% (95% confidence interval [CI]) with a median follow-up of 42 months (range, 3 to 114) and 85% +/- 11% (95% CI) with a median follow-up of 30.9 (range, 3 to 111) when patients were censored at the time of transplantation. Event-free survival at 5 years (adding death and transplant as event) was 46% +/- 11% (95% CI). Using proportional hazards regression to study time-dependent variables, we confirmed that the most significant factor associated with survival was the cytogenetic response (MCR or CCR) (P <.0001). This factor was independent compared with the Sokal score and baseline variables used to calculate the Sokal score. Moreover, using either univariate or multivariate analysis, the achievement of CHR within 3 months was strongly correlated with MCR (P <.0001). Minimum cytogenetic response (mCR, ie, at least 5% of Ph- metaphases) at 3 months was also a significant predictive factor for MCR (P <.0001). These results show that IFN- can induce a high rate of hematological and cytogenetic response when administered in doses leading to myelosuppression. Factors such as the achievement of CHR and mCR within 3 months could be useful to identify early those patients who will not respond to IFN- and who need alternative treatments such as stem cell transplantation.
Asunto(s)
Interferón Tipo I/administración & dosificación , Leucemia Mielógena Crónica BCR-ABL Positiva/tratamiento farmacológico , Leucemia Mielógena Crónica BCR-ABL Positiva/fisiopatología , Administración Cutánea , Adolescente , Adulto , Anciano , Niño , Femenino , Humanos , Leucemia Mielógena Crónica BCR-ABL Positiva/mortalidad , Masculino , Persona de Mediana Edad , Valor Predictivo de las Pruebas , Pronóstico , Proteínas Recombinantes , Análisis de Supervivencia , Factores de TiempoRESUMEN
Se presentan dos ninas de 3 meses y de 2 dias de vida, con cutis marmorata telangiectasica congenita no familar.En la primera, el reticulado marmoreo no es muy intenso pero si extendido, y se asocia con glaucoma congenito y leve asimetria en el electroencefalograma. En la mas pequena el reticulado es mucho mas marcado, y se asocia con anomalias multiples: paladar ojival, pulgar hundido bilateral, dedos largos con unas hipotroficas triangulares en ambos pies, plieque plantar anormal bilateral, circulacion colateral en abdomen.La tomografia computada de cerebro fue normal, lo mismo que el examen oftalmologico. Creemos que el nombre del sindrome debiera ser "cutis marmorata telangiectasica con multiples anomalias congenitas", debido a la asociacion de esta rara dermatosis con anormalidades mesodermicas y neuroectodermicas
Asunto(s)
Recién Nacido , Lactante , Humanos , Femenino , Anomalías Congénitas , Nevo , Trastornos de la Pigmentación , Úlcera Cutánea , TelangiectasiaRESUMEN
Se presentan dos ninas de 3 meses y de 2 dias de vida, con cutis marmorata telangiectasica congenita no familar.En la primera, el reticulado marmoreo no es muy intenso pero si extendido, y se asocia con glaucoma congenito y leve asimetria en el electroencefalograma. En la mas pequena el reticulado es mucho mas marcado, y se asocia con anomalias multiples: paladar ojival, pulgar hundido bilateral, dedos largos con unas hipotroficas triangulares en ambos pies, plieque plantar anormal bilateral, circulacion colateral en abdomen.La tomografia computada de cerebro fue normal, lo mismo que el examen oftalmologico. Creemos que el nombre del sindrome debiera ser "cutis marmorata telangiectasica con multiples anomalias congenitas", debido a la asociacion de esta rara dermatosis con anormalidades mesodermicas y neuroectodermicas
Asunto(s)
Recién Nacido , Lactante , Humanos , Femenino , Anomalías Congénitas , Trastornos de la Pigmentación , Nevo , Telangiectasia , Úlcera CutáneaRESUMEN
Presentamos dos pacientes con la triada disgnostica del Sindrome de Netherton:ictiosis lineal circunfleja,tricorresis invaginada y diatesis atopica.En ambos casos la biopsia de las lesiones de piel y la microscopia por barrido electronico,fueron decisivas para el diagnostico.Los hallazgos histopatologicos del borde externo de las lesiones fueron compatibles con dermatitis psoriasiforme.La tricorresis invaginada o pelo en caña de bambu,se encontro presente a lo largo del pelo.Las manifestaciones atopicas fueron inconstantes.La edad de los pacientes exigio el planteo de terapeuticas poco agresivas.
Asunto(s)
Diagnóstico Diferencial , Susceptibilidad a Enfermedades , Antagonistas de los Receptores Histamínicos H1/administración & dosificación , Ictiosis , Dermatosis del Cuero Cabelludo/patología , Enfermedades de la Piel/diagnóstico , Enfermedades de la Piel/terapia , Agentes Mojantes/administración & dosificación , Cabello , Enfermedades del Cabello , Cabeza/anatomía & histologíaRESUMEN
Presentamos dos pacientes con la triada disgnostica del Sindrome de Netherton:ictiosis lineal circunfleja,tricorresis invaginada y diatesis atopica.En ambos casos la biopsia de las lesiones de piel y la microscopia por barrido electronico,fueron decisivas para el diagnostico.Los hallazgos histopatologicos del borde externo de las lesiones fueron compatibles con dermatitis psoriasiforme.La tricorresis invaginada o pelo en caña de bambu,se encontro presente a lo largo del pelo.Las manifestaciones atopicas fueron inconstantes.La edad de los pacientes exigio el planteo de terapeuticas poco agresivas.AU