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1.
HIV Med ; 25(4): 424-439, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38092529

RESUMO

INTRODUCTION: Advancements in and accessibility to effective antiretroviral therapy has improved the life expectancy of people living with HIV, increasing the proportion of people living with HIV reaching older age (≥60 years), making this population's health-related quality of life (HRQoL) more relevant. Our aim was to identify the determinants of poor HRQoL in people living with HIV aged ≥60 years and compare them with those of their younger counterparts. METHODS: We used data from the 'Vive+' study, a cross-sectional survey conducted between October 2019 and March 2020, nested within the PISCIS cohort of people living with HIV in Catalonia and the Balearic Islands, Spain. We used the 12-item short-form survey (SF-12), divided into a physical component summary (PCS) and a mental component summary (MCS), to evaluate HRQoL. We used the least absolute shrinkage and selection operator for variable selection and used multivariable regression models to identify predictors. RESULTS: Of the 1060 people living with HIV (78.6% males) who participated in the study, 209 (19.7%) were aged ≥60 years. When comparing older people living with HIV (≥60 years) and their younger counterparts, older people exhibited a worse PCS (median 51.3 [interquartile range {IQR} 46.0-58.1] vs. 46.43 [IQR 42.5-52.7], p < 0.001) but a similar MCS (median 56.0 [IQR 49.34-64.7] vs. 57.0 [IQR 48.9-66.3], p = 0.476). In the multivariable analysis, cognitive function correlated with a PCS (ß correlation factor [ß] -0.18, p = 0.014), and depressive symptoms and satisfaction with social role correlated with an MCS (ß 0.61 and ß -0.97, respectively, p < 0.001) in people living with HIV aged ≥60 years. CONCLUSION: Depressive symptoms, poor cognitive function, and lower satisfaction with social roles predict poorer HRQoL in older people living with HIV. These factors need to be considered when designing targeted interventions.


Assuntos
Infecções por HIV , Qualidade de Vida , Masculino , Humanos , Idoso , Feminino , Qualidade de Vida/psicologia , Estudos Transversais , Infecções por HIV/tratamento farmacológico , Infecções por HIV/psicologia , Inquéritos e Questionários , Cognição
2.
J Nucl Med ; 36(9): 1539-42, 1995 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-7658207

RESUMO

UNLABELLED: We studied 355 patients with Grave's disease to characterize transient hypothyroidism and its prognostic value following 131I therapy. METHODS: The patients received therapeutic 131I treatment as follows: 333 received a dose < 10 mCi (6.6 +/- 1.9 mCi) and 22 received a dose > 10 mCi (12.8 +/- 2.9 mCi). Diagnosis of transient hypothyroidism was based on low T4, regardless of TSH within the first year after 131I followed by recovery of T4 and normal TSH. RESULTS: After administration of < 10 mCi 131I, 40 patients developed transient hypothyroidism during the first year; transient hypothyroidism was symptomatic in 15. There was no transient hypothyroidism after high doses (> 10 mCi) of 131I. Iodine-131 uptake > 70% at 2 hr before treatment was a risk factor for developing transient hypothyroidism (Odds ratio 2.8, 95% confidence interval 0.9-9.4). At diagnosis of transient hypothyroidism, basal TSH levels were high (51%), normal (35%) or low (14%); therefore, the transient hypothyroidism was not centralized. If hypothyroidism developed during the first 6 mo after basal TSH > 45 mU/liter ruled out transient hypothyroidism. CONCLUSION: The development of transient hypothyroidism and its hormonal pattern did not influence long-term thyroid function. Since no prognostic factors reliably predicted transient hypothyroidism before 131I or at the time of diagnosis, if hypothyroidism appears within the first months after 131I, the reevaluation of thyroid function later is warranted to avoid unnecessary chronic replacement therapy.


Assuntos
Doença de Graves/radioterapia , Hipotireoidismo/etiologia , Radioisótopos do Iodo/uso terapêutico , Feminino , Humanos , Hipotireoidismo/sangue , Radioisótopos do Iodo/efeitos adversos , Tábuas de Vida , Masculino , Pessoa de Meia-Idade , Prognóstico , Radioterapia/efeitos adversos , Dosagem Radioterapêutica , Fatores de Risco , Tireotropina/sangue , Tiroxina/sangue , Tri-Iodotironina/sangue
3.
Histol Histopathol ; 16(1): 99-106, 2001 01.
Artigo em Inglês | MEDLINE | ID: mdl-11193217

RESUMO

The p53 gene is located on the short arm of chromosome 17. It encodes a 53-kd nuclear protein (p53) found in scant amounts in normal tissue. Mutations of the p53 gene have been reported in different human tumours. In breast cancer, it has been noted that the overexpression of p53 protein in the nucleus is an indicator of poor prognosis, although there is a high degree of variability, which may be due to different immunohistochemical techniques, varying assessment of results and the type of monoclonal antibody used. This study is an immunohistochemical analysis of p53 expression in 192 cases of infiltrating ductal carcinoma of the breast, correlating it with clinicopathological factors and the clinical course of the disease. Of all the breast-cancer tissue analysed, stains for p53 antibody were found in 87 tumours (45.3%). The results of multivariate analysis show that the independent predictors related to recurrence are tumour size, lymph-node metastasis and p53, while those related to death are necrosis, lymph-node metastasis and p53. In summary, our series showed prognostic significance between the expression of p53 and shorter survival time and disease-free interval for all patients in general as well as those who presented lymph-node metastases at the time of diagnosis.


Assuntos
Neoplasias da Mama/metabolismo , Neoplasias da Mama/patologia , Carcinoma Ductal de Mama/metabolismo , Carcinoma Ductal de Mama/patologia , Proteína Supressora de Tumor p53/biossíntese , Adulto , Idoso , Idoso de 80 Anos ou mais , Biomarcadores Tumorais , Feminino , Humanos , Imuno-Histoquímica , Linfonodos/metabolismo , Linfonodos/patologia , Pessoa de Meia-Idade , Análise Multivariada , Valor Preditivo dos Testes , Prognóstico , Análise de Sobrevida , Resultado do Tratamento
4.
Rev Esp Enferm Dig ; 87(5): 393-6, 1995 May.
Artigo em Espanhol | MEDLINE | ID: mdl-7626299

RESUMO

The lower digestive tract, in contrast to the gastroduodenal tract, is infrequently affected by non-steroidal antiinflammatory drugs (NSAID), and rarely referred to in medical literature. We report the case of a 40-year-old man who presented with bloody diarrhea following treatment with NSAID. The fiber gastroscopy was normal. The fiber colonoscopy showed elongated aphthous ulcers with fibrin in the sigmoid colon. Others studies were normal. After withdrawal of NSAID, the patient returned to normal, as did the fiber colonoscopy. The treatment with NSAID has been linked with ulcerative lesions in the lower digestive tract, perforation, bloody lesions, perforation of diverticuli, reactivation of quiescent colitis and stenosis. In spite of this, doubts persist about the frequency of presentation, high risk doses and its pathophysiological mechanism, which probably involves blocking the cyclooxigenase system and the formation of the leukotrienes and free oxygen radicals. Taking into consideration the above factors, more care should be taken in investigating colonic involvement in patients who present with gastrointestinal bleeding following treatment with NSAID.


Assuntos
Anti-Inflamatórios não Esteroides/efeitos adversos , Colite Ulcerativa/induzido quimicamente , Diarreia/induzido quimicamente , Hemorragia Gastrointestinal/induzido quimicamente , Doenças Retais/induzido quimicamente , Adulto , Colite Ulcerativa/diagnóstico , Colite Ulcerativa/patologia , Diarreia/diagnóstico , Diarreia/patologia , Hemorragia Gastrointestinal/diagnóstico , Hemorragia Gastrointestinal/patologia , Humanos , Masculino , Doenças Retais/diagnóstico , Doenças Retais/patologia
5.
Rev Esp Enferm Dig ; 81(4): 285-7, 1992 Apr.
Artigo em Espanhol | MEDLINE | ID: mdl-1599770

RESUMO

Acute hepatitis A virus infection (HAV) is a benign, self limited disease with infrequent extrahepatic features unlike the hepatitis B or the nonA-nonB virus infection. We describe the case of a 37 year old white woman with HAV who had a relapse with a second elevation of the alanine aminotransferase level together with joint pain, skin lesions, angioneurotic edema, and autoantibodies (ANA, anti smooth muscle, antiparietal gastric cells). The liver biopsy showed piecemeal and early bridging necrosis. She had a rapid reversal of her clinical, biochemical and histological abnormalities. As far as we known, this is the first reported case of autoantibodies or angioneurotic edema associated with HAV. We comment on the pathogenesis of this rare association.


Assuntos
Doenças Autoimunes/complicações , Hepatite A/complicações , Adulto , Feminino , Humanos
6.
An Med Interna ; 13(8): 390-2, 1996 Aug.
Artigo em Espanhol | MEDLINE | ID: mdl-8983366

RESUMO

Ocular toxoplasmosis is an uncommon complication of acquired immunodeficiency syndrome (AIDS), and it is generally described associated with central nervous system (CNS) lesions. We describe two cases of ocular toxoplasmosis in human immunodeficiency virus (HIV) infected patients, without concurrent CNS infection. Both developed bilateral or unilateral choriorretinitis with favorable response to antitoxoplasma therapy. None of them presented toxoplasmosis of the CNS coexisting with ocular lesions. Ocular toxoplasmosis should be considered in HIV infected patients although no involvement of the CNS is found.


Assuntos
Infecções por HIV/complicações , Toxoplasmose Ocular/complicações , Adulto , Humanos , Masculino , Toxoplasmose Ocular/diagnóstico
7.
An Med Interna ; 10(2): 77-9, 1993 Feb.
Artigo em Espanhol | MEDLINE | ID: mdl-8452977

RESUMO

Tracheobronchial amyloidosis is the most frequent manifestation of pulmonary amyloidosis. We present the case of a patient who initially presented pneumonia with atelectasis in the upper right lobe (URL) and in whom the presence of nodular bodies in all the bronchial tree was detected with bronchoscopy, with almost complete obstruction of the URL bronchus, identified as amyloid AL. Therapy with laser photoresection was effective, with almost complete resolution of the obstruction.


Assuntos
Amiloidose/diagnóstico , Broncopatias/diagnóstico , Doenças da Traqueia/diagnóstico , Idoso , Amiloidose/cirurgia , Broncopatias/cirurgia , Feminino , Humanos , Terapia a Laser , Doenças da Traqueia/cirurgia
11.
Eur J Clin Microbiol Infect Dis ; 16(11): 843-5, 1997 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-9447908

RESUMO

The infecting pathogens most commonly implicated in prosthetic joint infections are staphylococci, streptococci, and gram-negative rods. Prosthetic infections caused by Brucella spp. are rarely described in the literature. Treatment of prosthetic infections remains complex and controversial, the most accepted course being antibiotic treatment with removal or retention of prosthetic components. The case of a 60-year-old man who developed Brucella septic arthritis of the right knee in a total knee replacement is reported. Conservative treatment using a three-drug therapy was employed, with excellent results.


Assuntos
Artrite Infecciosa/etiologia , Artroplastia do Joelho/efeitos adversos , Brucelose/etiologia , Humanos , Masculino , Pessoa de Meia-Idade
15.
Rev. senol. patol. mamar. (Ed. impr.) ; 13(4): 184-191, oct. 2000. graf, tab, ilus
Artigo em Es | IBECS (Espanha) | ID: ibc-3619

RESUMO

Objetivo. Valorar la relación entre los factores pronósticos clínicos, histológicos e inmunohistoquímicos en el carcinoma ductal infiltrante de mama. Material y métodos. Se estudiaron variables clínicas e histológicas, receptores hormonales e índice de proliferación celular (Ki-67) en 192 pacientes con carcinoma ductal infiltrante. Los receptores de estrógenos y progesterona fueron medidos de acuerdo con la intensidad de la tinción (I), con valores comprendidos entre 0 y 3, y el porcentaje de células positivas (P). Se calculó un histoscore para la fórmula (I + 1) × P (rango: 0-400). Los casos con un valor de histoscore por encima de 100 fueron considerados positivos. El índice de proliferación celular (Ki-67) fue medido contando 500 células, expresando el número de células positivas en porcentaje. Resultados.En 64,24 por ciento de los tumores se encontró tinción positiva para los receptores de estrógenos, mientras que el 49,12 por ciento fueron receptores de progesterona positivos. En 21,87 por ciento de los pacientes se encontró un índice de proliferación celular alto (> 25 por ciento). El tamaño tumoral, el número de mitosis, la presencia de necrosis y el estado ganglionar fueron factores pronósticos independientes en nuestro estudio estadístico. Conclusiones. Los receptores hormonales y el Ki-67 no son factores pronósticos independientes para la recidiva y la supervivencia global en nuestro estudio. Sólo los factores histológicos clásicos se han mostrado como factores pronósticos independientes. (AU)


Assuntos
Adulto , Idoso , Feminino , Pessoa de Meia-Idade , Humanos , Antígeno Ki-67 , Carcinoma Ductal de Mama/diagnóstico , Neoplasias da Mama/diagnóstico , Receptores de Estrogênio , Receptores de Progesterona , Imuno-Histoquímica/métodos , Prognóstico , Estrogênios , Progesterona , Metástase Neoplásica , Neoplasias da Mama/cirurgia , Carcinoma Ductal de Mama/cirurgia
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