Assuntos
Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Terapia Antirretroviral de Alta Atividade/efeitos adversos , Granuloma/induzido quimicamente , Sarcoidose/induzido quimicamente , Dermatopatias/induzido quimicamente , Tatuagem/efeitos adversos , Adulto , Granuloma/patologia , Humanos , Masculino , Sarcoidose/patologia , Dermatopatias/patologiaRESUMO
An immunosuppressed patient who presented with unusual clinical signs of cutaneous alternariosis, including papular, nodular and verrucous lesions of the forearms, is reported. In spite of continuous treatment with oral itraconazole for 6 months, a large, progressive, necrotic ulcer appeared on the patient's left leg. Liposomal amphotericin B was then administered (total dose, 750 mg) with excellent clinical results.
Assuntos
Alternaria/efeitos dos fármacos , Alternaria/isolamento & purificação , Anfotericina B/administração & dosagem , Antifúngicos/administração & dosagem , Dermatomicoses/tratamento farmacológico , Transplante de Rim/imunologia , Úlcera da Perna/tratamento farmacológico , Infecções Oportunistas/tratamento farmacológico , Biópsia por Agulha , Dermatomicoses/diagnóstico , Dermatomicoses/imunologia , Seguimentos , Humanos , Hospedeiro Imunocomprometido , Imuno-Histoquímica , Úlcera da Perna/microbiologia , Lipossomos , Masculino , Pessoa de Meia-Idade , Infecções Oportunistas/diagnóstico , Infecções Oportunistas/imunologia , Recidiva , Medição de Risco , Índice de Gravidade de Doença , Resultado do TratamentoRESUMO
Progressive multifocal leukoencephalopathy (PML) has been a devastating disease for HIV-1-infected patients since the beginning of the AIDS pandemic. Currently, highly active antiretroviral therapy (HAART) seems to improve the outcome of PML in many patients. We describe two cases of PML whose course worsened in spite of HAART, but had a good response to cidofovir.
Assuntos
Infecções Oportunistas Relacionadas com a AIDS/tratamento farmacológico , Antivirais/uso terapêutico , Citosina/análogos & derivados , Leucoencefalopatia Multifocal Progressiva/tratamento farmacológico , Organofosfonatos , Compostos Organofosforados/uso terapêutico , Adulto , Terapia Antirretroviral de Alta Atividade , Cidofovir , Citosina/uso terapêutico , Feminino , Infecções por HIV/tratamento farmacológico , HIV-1 , Humanos , MasculinoRESUMO
The urinary concentration of acetaminophen and its glucuronide, sulphate, cysteine, and mercapturate conjugates was measured by high-performance liquid chromatography in 32 healthy volunteers, 9 untreated symptom-free HIV-seropositive subjects, and 19 patients with AIDS after a single oral dose of 1.5 g of acetaminophen. The concentration of the glucuronide conjugate was significantly lower in AIDS patients when simultaneously compared with concentrations found in healthy individuals and symptoms-free HIV-seropositive subjects. Differences between healthy volunteers and symptom-free HIV seropositives were not encountered. By contrast, urinary concentrations of sulphate and oxidation pathway-derived metabolites were significantly higher in AIDS patients as compared with the other two groups. When AIDS patients treated with zidovudine were compared with those not given this medication, differences in the urinary excretion of acetaminophen and its metabolites were not observed. However, the urinary concentration of mercapturic acid was significantly higher in those given enzyme inducers, such as rifampicin or phenytoin, than in AIDS patients not treated with these drugs. In summary, patients with advanced HIV infection showed reduced acetaminophen glucuronidation and increased formation of the hepatotoxic oxidation metabolites, which was independent of zidovudine therapy.
Assuntos
Acetaminofen/metabolismo , Síndrome da Imunodeficiência Adquirida/metabolismo , Analgésicos não Narcóticos/metabolismo , Soropositividade para HIV/metabolismo , Acetaminofen/urina , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Adulto , Analgésicos não Narcóticos/urina , Antivirais/uso terapêutico , Feminino , Humanos , Masculino , Valores de Referência , Zidovudina/uso terapêuticoAssuntos
Alopurinol/uso terapêutico , Fluconazol/uso terapêutico , Leishmaniose Visceral/tratamento farmacológico , Síndrome da Imunodeficiência Adquirida/complicações , Síndrome da Imunodeficiência Adquirida/tratamento farmacológico , Adulto , Antifúngicos/uso terapêutico , Antimetabólitos/uso terapêutico , Medula Óssea/microbiologia , Quimioterapia Combinada , Inibidores Enzimáticos/uso terapêutico , Feminino , Humanos , Hospedeiro Imunocomprometido , Transplante de Rim , Leishmaniose Visceral/complicações , MasculinoRESUMO
Three new cases of intraosseous lipoma of the os calcis were investigated, and the literature on nine previously reported cases was reviewed. Computed tomography (CT) was employed to diagnose the lesions preoperatively. CT energy attenuation of the lesions and fatty tissues showed similar patterns. The preoperative diagnoses suggested by clinical, anatomic, and radiologic studies were later confirmed by excision biopsy.