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ABSTRACT Certain open access publishers based on the article processing charges model have found it highly profitable to operate within a gray zone that encompasses both legitimate and predatory publishing practices. In this context, maximum profits can be obtained by adequate combinations of journal acceptance rates and elevated article processing charges. Considering that the gray zone can be particularly challenging to identify and that it poses risks for authors aiming to establish academic carreers, we believe it is important to provide a comprehensive description of it.
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Certain open access publishers based on the article processing charges model have found it highly profitable to operate within a gray zone that encompasses both legitimate and predatory publishing practices. In this context, maximum profits can be obtained by adequate combinations of journal acceptance rates and elevated article processing charges. Considering that the gray zone can be particularly challenging to identify and that it poses risks for authors aiming to establish academic carreers, we believe it is important to provide a comprehensive description of it.
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Acceso a la Información , Publicación de Acceso Abierto , Humanos , EdiciónRESUMEN
The level of knowledge that people living with human immunodeficiency virus (HIV) have about their disease can impact their adherence to treatment. The aim of this study was to develop a tool to assess the knowledge about HIV among people receiving treatment at a specialized clinic in Mexico City. To establish content validity, expert judges were invited to conceptualize the tool and propose items for the defined dimensions. A total of 490 individuals living with HIV completed the 91-item questionnaire, with 82.2% being male and a mean age of 36.1 years. We conducted an exploratory factor analysis, resulting in a reduced questionnaire of 45 questions. A three-factor solution explained 36.2% of the variance in HIV knowledge. The total scale had a reliability coefficient of 0.937, and each subscale had reliabilities of 0.828, 0.856 and 0.859. Lower educational level (F(336)â =â 8.488, pâ <â 0.001) and female gender (t(399)â =â 2.003, pâ =â 0.046) were associated with lower scores on the HIV knowledge questionnaire. This tool appears suitable for measuring HIV knowledge in people living with HIV, although future studies are required to confirm its structure and reduce its extension.
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Infecciones por VIH , VIH , Conocimientos, Actitudes y Práctica en Salud , Adulto , Femenino , Humanos , Masculino , México , Psicometría/métodos , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
Purpose: This study aimed to assess the level of anxiety and depression in relatives of critically ill COVID-19 patients admitted to the intensive care unit (ICU), and to perform an exploratory pilot study on the implementation of telephone psychological interventions to reduce the initial levels of anxiety and depression in this population. Patients and Methods: Family members of COVID-19 inpatients at ICU answered GAD-7, PHQ-9 and questions on socio-demographic data. A brief psychological intervention was applied via telephone based on the needs of the participants (with adequate adaptation, with symptoms of anxiety, depression, or both). After intervention, participants completed the Patient Global Impression of Change Scale. Results: A total of 1307 relatives were included (66.5% female), 34% and 29% had anxiety and depressive symptoms, respectively. These symptoms were associated with female gender, unemployment, and being the parent or partner of the patient. After intervention, 57.9% reported felt better, 31.3% a little better and 6.6% much better; and with emotional regulation techniques and psychoeducation, higher percentages of feeling better or much better were reported. Conclusion: Brief interventions to reduce the psychological impact of inpatient family members could be effective but will need to be explored further in future studies.
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BACKGROUND: The mental health and medical follow-up of people living with HIV (PLWH) have been disrupted by the COVID-19 pandemic. The objectives of this study were to assess anxiety, depression and substance use in Mexican PLWH during the pandemic; to explore the association of these symptoms with adherence to antiretroviral therapy (ART), and to compare patients with and without vulnerability factors (low socioeconomic level, previous psychological and/or psychiatric treatment). METHODS: We studied 1259 participants in a cross-sectional study, PLWH receiving care at the HIV clinic in Mexico City were contacted by telephone and invited to participate in the study. We included PLWH were receiving ART; answered a structured interview on sociodemographic data and adherence to ART; and completed the psychological instruments to assess depressive and anxiety symptoms and substance use risk. Data collection was performed from June 2020 to October 2021. RESULTS: 84.7% were men, 8% had inadequate ART adherence, 11% had moderate-severe symptoms of depression, and 13% had moderate-severe symptoms of anxiety. Adherence was related to psychological symptoms (p < 0.001). Vulnerable patients were more likely to be women, with low educational level and unemployed (p < 0.001). CONCLUSIONS: It is important to address mental health of PLWH during the COVID-19 pandemic, with special attention to the most vulnerable individuals. Future studies are needed to understand the relationship between mental health and ART adherence.
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COVID-19 , Infecciones por VIH , Trastornos Relacionados con Sustancias , Masculino , Humanos , Femenino , Infecciones por VIH/tratamiento farmacológico , Infecciones por VIH/epidemiología , Infecciones por VIH/psicología , Pandemias , Salud Mental , Estudios Transversales , México/epidemiología , Cumplimiento de la Medicación , COVID-19/epidemiología , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
Double-negative (DN) T cells represent a small and phenotypically heterogeneous population that display regulatory functions. In HIV infection, DN T cells are decreased in peripheral blood and have been negatively associated with T cell activation. This study was aimed at describing the dynamics and phenotypic characteristics of DN T cells in peripheral blood of people living with HIV (PLHIV) before and after antiretroviral therapy (ART) initiation. We included 41 newly diagnosed, ART-naive individuals with advanced HIV infection, who were followed up for 6 months after ART initiation. The control group included 34 people without HIV (PWHIV), on preexposure prophylaxis for HIV infection. DN T cells in peripheral blood were characterized by flow cytometry. The absolute counts of DN T cells were lower in PLHIV than in PWHIV (p = 0.0223), and were particularly low in individuals with advanced HIV disease (p = 0.0311). Activation of DN T cells before ART initiation was directly associated with viral load (VL) (p = 0.0081, r = 0.4083) and inversely associated with CD4+ T cell counts (p = 0.0004, r = -0.4041). Compared with PWHIV, DN T cells of PLHIV expressed higher levels of CD57 (p = 0.0019), Ki67 (p = 0.0065), PD-1 (p = 0.0187), and CD38/HLA-DR (p < 0.0001). After 6 months on ART, expression of Ki67, PD-1, and CD38/HLA-DR on DN T cells returned to similar levels to those observed in PWHIV (p > 0.05 in all cases). However, expression of CD57 decreased only in individuals that start ART with high VL (p = 0.0127). DN T cell counts are decreased in HIV infection. Low DN T cell counts remained despite ART-induced immune reconstitution and viremia control. DN T cell phenotype is altered during chronic untreated infection with a high proportion of proliferating, activated, exhausted, and senescent cells. Most markers return to levels similar to those observed in PWHIV after ART. The impact of altered phenotype of DN T and their regulatory functions warrants further exploration.
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Infecciones por VIH , VIH-1 , Humanos , Linfocitos T , Receptor de Muerte Celular Programada 1 , Antígeno Ki-67 , Antirretrovirales/uso terapéutico , Antígenos HLA-DR/uso terapéutico , Fenotipo , Recuento de Linfocitos , Linfocitos T CD4-Positivos , Carga Viral , Linfocitos T CD8-positivos , Activación de LinfocitosRESUMEN
In hospitalized COVID-19 patients, disease progression leading to acute kidney injury (AKI) may be driven by immune dysregulation. We explored the role of urinary cytokines and their relationship with kidney stress biomarkers in COVID-19 patients before and after the development of AKI. Of 51 patients, 54.9% developed AKI. The principal component analysis indicated that in subclinical AKI, epidermal growth factor (EGF) and interferon (IFN)-α were associated with a lower risk of AKI, while interleukin-12 (IL-12) and macrophage inflammatory protein (MIP)-1ß were associated with a higher risk of AKI. After the manifestation of AKI, EGF and IFN-α remained associated with a lower risk of AKI, while IL-1 receptor (IL-1R), granulocyte-colony stimulating factor (G-CSF), interferon-gamma-inducible protein 10 (IP-10) and IL-5 were associated with a higher risk of AKI. EGF had an inverse correlation with kidney stress biomarkers. Subclinical AKI was characterized by a significant up-regulation of kidney stress biomarkers and proinflammatory cytokines. The lack of EGF regenerative effects and IFN-α antiviral activity seemed crucial for renal disease progression. AKI involved a proinflammatory urinary cytokine storm.
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Lesión Renal Aguda , COVID-19 , Humanos , Citocinas , Factor de Crecimiento Epidérmico , COVID-19/complicaciones , Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/etiología , Biomarcadores , Progresión de la Enfermedad , Lipocalina 2RESUMEN
OBJECTIVES: After surgical resection of papilloma, adjuvant therapy may be recommended for the control of recurrent respiratory papillomatosis (RRP). As the efficacy of adjuvant therapy remains unproven, the aim of this study was to compare the efficacy of cidofovir versus bevacizumab used as adjuvant therapies for the control of RRP. METHODS: This randomized, double-blind, placebo-controlled pilot study was performed in a national respiratory disease referral centre. Patients with RRP were recruited prospectively and were divided into juvenile or adult RRP. Participants were randomly assigned to receive adjuvant therapy with cidofovir, bevacizumab or placebo. The study drug or placebo was administered after direct microlaryngoscopy with papilloma resection using cold instruments. The Derkay severity score and the Voice Handicap Index (VHI) were assessed at 3-6-week intervals, for a total of 3 visits. Follow-up included VHI and Derkay score assessments at 2-month intervals over the course of one year. Annual rates before and after surgical treatment were compared. RESULTS: Five children and 11 adults were enrolled in the study. After one year, the group treated with cidofovir had a significant decrease in Derkay score (p=.027). No difference between treatment arms was observed in the annual surgery rate. There was a significant decrease in the VHI score in all treatment groups (p<.001), and no significant difference was observed between groups (p=.32). CONCLUSION: While we observed a significant decrease in RRP severity with intralesional cidofovir, we were unable to provide proof of efficacy of intralesional bevacizumab. CLINICALTRIALS: gov Identifier: NCT02555800.
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Papiloma , Adulto , Bevacizumab/uso terapéutico , Niño , Cidofovir/uso terapéutico , Humanos , Papiloma/tratamiento farmacológico , Papiloma/cirugía , Infecciones por Papillomavirus , Proyectos Piloto , Infecciones del Sistema RespiratorioRESUMEN
Objectives: After surgical resection of papilloma, adjuvant therapy may be recommended for the control of recurrent respiratory papillomatosis (RRP). As the efficacy of adjuvant therapy remains unproven, the aim of this study was to compare the efficacy of cidofovir versus bevacizumab used as adjuvant therapies for the control of RRP. Methods: This randomized, double-blind, placebo-controlled pilot study was performed in a national respiratory disease referral centre. Patients with RRP were recruited prospectively and were divided into juvenile or adult RRP. Participants were randomly assigned to receive adjuvant therapy with cidofovir, bevacizumab or placebo. The study drug or placebo was administered after direct microlaryngoscopy with papilloma resection using cold instruments. The Derkay severity score and the Voice Handicap Index (VHI) were assessed at 36-week intervals, for a total of 3 visits. Follow-up included VHI and Derkay score assessments at 2-month intervals over the course of one year. Annual rates before and after surgical treatment were compared. Results: Five children and 11 adults were enrolled in the study. After one year, the group treated with cidofovir had a significant decrease in Derkay score (p=.027). No difference between treatment arms was observed in the annual surgery rate. There was a significant decrease in the VHI score in all treatment groups (p<.001), and no significant difference was observed between groups (p=.32). Conclusion: While we observed a significant decrease in RRP severity with intralesional cidofovir, we were unable to provide proof of efficacy of intralesional bevacizumab. (AU)
Objetivos: Tras la extirpación quirúrgica de los papilomas, puede recomendarse terapia adyuvante para el control de la papilomatosis respiratoria recurrente (PRR). Como la eficacia de la terapia adyuvante no está demostrada, el objetivo de este estudio fue comparar la eficacia de cidofovir frente a bevacizumab, utilizados como terapias adyuvantes para el control de PRR. Métodos: Estudio piloto aleatorizado, doble ciego y controlado por placebo, realizado en un centro nacional de referencia de enfermedades respiratorias. Se reclutó prospectivamente a los pacientes con PRR, y se dividieron en 2 grupos: PRR de jóvenes y PRR de adultos. A los participantes se les asignó aleatoriamente la administración de terapia adyuvante de cidofovir, bevacizumab o placebo. La administración de los fármacos de estudio o placebo se realizó tras practicar microlaringoscopia directa con extirpación de papilomas, utilizando instrumental frío. Se llevaron a cabo evaluaciones utilizando la puntuación de gravedad de Derkay y la escala VHI (Voice Handicap Index) a intervalos de 3 a 6 semanas, con un total de 3 visitas. El seguimiento incluyó evaluación de las escalas VHI y Derkay a intervalos de 2 meses, durante el curso de un año. Se compararon las tasas anuales pre- y postratamiento quirúrgico. Resultados: El estudio incluyó 5 niños y 11 adultos. Transcurrido un año, el grupo tratado con cidofovir reflejó una reducción significativa en la escala Derkay (p=0,027). No se observó diferencia alguna entre las ramas terapéuticas en la tasa quirúrgica anual. Se vio una reducción significativa en la puntuación VHI en todos los grupos terapéuticos (p<0,001), y no se observó diferencia significativa entre los grupos (p=0,32). Conclusión: A pesar de verse una reducción significativa de la gravedad de PRR con la administración de cidofovir intralesional, no pudimos probar la eficacia de bevacizumab intralesional. (AU)
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Humanos , Ciencias de la Salud , Papiloma/cirugía , Cidofovir , Bevacizumab , Ensayos Clínicos Controlados Aleatorios como AsuntoRESUMEN
PURPOSE: To describe ophthalmological fundoscopic findings in patients with COVID-19 admitted to the intensive care unit of the largest third-level referral center for COVID-19 in Mexico City. METHODS: In this cross-sectional single-center study, consecutive patients admitted to the intensive care unit with a diagnosis of COVID-19 underwent fundus examination with an indirect ophthalmoscope. Clinical photographs were taken using a posterior-pole camera. We explored the association between ocular manifestations and demographic characteristics, inflammatory markers, hemodynamic factors, and comorbidities. RESULTS: Of 117 patients examined, 74 were men; the median age was 54 years (range: 45-63 years). Forty-two patients had ophthalmological manifestations (unilateral in 23 and bilateral in 19), and 10 of these patients had more than one ophthalmological manifestation. Ocular findings were papillitis (n = 13), cotton wool spots (n = 12), retinal hemorrhages (n = 5), retinal nerve fiber layer edema (n = 8), macular whitening (n = 5), retinal vascular tortuosity (n = 4), papillophlebitis (n = 3), central retinal vein occlusion (n = 1), and branch retinal vein occlusion (n = 1). Ocular fundus manifestations were not associated with demographic characteristics, inflammatory markers, hemodynamic factors, or comorbidities. CONCLUSION: More than one-third of patients with severe COVID-19 had ophthalmological manifestations. The most frequent fundoscopic findings were optic nerve inflammation, microvasculature occlusion, and major vascular occlusions. We recommend long-term follow-up to prevent permanent ocular sequelae.
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COVID-19 , Oclusión de la Vena Retiniana , COVID-19/epidemiología , Enfermedad Crítica , Estudios Transversales , Fondo de Ojo , Humanos , Masculino , Persona de Mediana Edad , Oclusión de la Vena Retiniana/diagnósticoRESUMEN
A high proportion of critically ill patients with COVID-19 develop acute kidney injury (AKI) and die. The early recognition of subclinical AKI could contribute to AKI prevention. Therefore, this study was aimed at exploring the role of the urinary biomarkers NGAL and [TIMP-2] × [IGFBP7] for the early detection of AKI in this population. This prospective, longitudinal cohort study included critically ill COVID-19 patients without AKI at study entry. Urine samples were collected on admission to critical care areas for determination of NGAL and [TIMP-2] × [IGFBP7] concentrations. The demographic information, comorbidities, clinical, and laboratory data were recorded. The study outcomes were the development of AKI and mortality during hospitalization. Of the 51 individuals that were studied, 25 developed AKI during hospitalization (49%). Of those, 12 had persistent AKI (23.5%). The risk factors for AKI were male gender (HR = 7.57, 95% CI: 1.28-44.8; p = 0.026) and [TIMP-2] × [IGFBP7] ≥ 0.2 (ng/mL)2/1000 (HR = 7.23, 95% CI: 0.99-52.4; p = 0.050). Mortality during hospitalization was significantly higher in the group with AKI than in the group without AKI (p = 0.004). Persistent AKI was a risk factor for mortality (HR = 7.42, 95% CI: 1.04-53.04; p = 0.046). AKI was frequent in critically ill COVID-19 patients. The combination of [TIMP-2] × [IGFBP7] together with clinical information, were useful for the identification of subclinical AKI in critically ill COVID-19 patients. The role of additional biomarkers and their possible combinations for detection of AKI in ritically ill COVID-19 patients remains to be explored in large clinical trials.
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Lesión Renal Aguda/diagnóstico , Lesión Renal Aguda/orina , COVID-19/diagnóstico , COVID-19/orina , Enfermedad Crítica/mortalidad , Lesión Renal Aguda/complicaciones , Lesión Renal Aguda/mortalidad , Adulto , Anciano , Biomarcadores/orina , COVID-19/complicaciones , COVID-19/mortalidad , Femenino , Humanos , Proteínas de Unión a Factor de Crecimiento Similar a la Insulina/orina , Estimación de Kaplan-Meier , Lipocalina 2/orina , Estudios Longitudinales , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Factores de Riesgo , Inhibidor Tisular de Metaloproteinasa-2/orinaRESUMEN
Our aim was to assess the severity of anxiety in PLWHA in Mexico City and obtain the psychometric properties of the culturally-adapted Spanish version of GAD-7. Thirteen percent of participants presented moderate to severe symptoms. Reliability (α = 0.82) and construct validity (single-factor explained 48.9% of variance) were evaluated in 411 participants. Confirmatory Factor Analysis was performed in a second sample of 527 participants. Model fit adequately (CFI = 0.991; CMIN/DF = 1.924; RMSEA = 0.042; and SRMR = 0.026). The adapted version of GAD-7 was adequate for the assessment of anxiety in Mexican PLWHA.
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Infecciones por VIH , Cuestionario de Salud del Paciente , Ansiedad/diagnóstico , Infecciones por VIH/diagnóstico , Humanos , México , Psicometría , Reproducibilidad de los Resultados , Encuestas y CuestionariosRESUMEN
OBJECTIVES: After surgical resection of papilloma, adjuvant therapy may be recommended for the control of recurrent respiratory papillomatosis (RRP). As the efficacy of adjuvant therapy remains unproven, the aim of this study was to compare the efficacy of cidofovir versus bevacizumab used as adjuvant therapies for the control of RRP. METHODS: This randomized, double-blind, placebo-controlled pilot study was performed in a national respiratory disease referral centre. Patients with RRP were recruited prospectively and were divided into juvenile or adult RRP. Participants were randomly assigned to receive adjuvant therapy with cidofovir, bevacizumab or placebo. The study drug or placebo was administered after direct microlaryngoscopy with papilloma resection using cold instruments. The Derkay severity score and the Voice Handicap Index (VHI) were assessed at 3-6-week intervals, for a total of 3 visits. Follow-up included VHI and Derkay score assessments at 2-month intervals over the course of one year. Annual rates before and after surgical treatment were compared. RESULTS: Five children and 11 adults were enrolled in the study. After one year, the group treated with cidofovir had a significant decrease in Derkay score (p=.027). No difference between treatment arms was observed in the annual surgery rate. There was a significant decrease in the VHI score in all treatment groups (p<.001), and no significant difference was observed between groups (p=.32). CONCLUSION: While we observed a significant decrease in RRP severity with intralesional cidofovir, we were unable to provide proof of efficacy of intralesional bevacizumab. Clinicaltrials.gov Identifier: NCT02555800.
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The most common neurologic symptoms in COVID-19 are headache, anosmia, and dysgeusia. Optic neuritis is an unusual manifestation of SARS-CoV-2 infection. We report a case of a patient who initially consulted for vision loss in the absence of respiratory symptoms. She was diagnosed with optic neuritis following SARS-CoV-2 infection. Delay in diagnosis of neuro-ophthalmic manifestations of COVID-19 may lead to irreversible optic atrophy. A mechanism in which viral antigens would induce an immune response against self-proteins, or direct SARS Cov-2 infection of the central nervous system, may be involved in optic nerve injury.
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COVID-19/complicaciones , Neuritis Óptica/virología , Femenino , Humanos , Persona de Mediana Edad , SARS-CoV-2RESUMEN
INTRODUCTION: Some patients with COVID-19 pneumonia present systemic disease involving multiple systems. There is limited information about the clinical characteristics and events leading to acute kidney injury (AKI). We described the factors associated with the development of AKI and explored the relation of AKI and mortality in Mexican population with severe COVID-19. METHODS: We retrospectively reviewed the medical records of individuals with severe pneumonia caused by SARS-CoV-2 hospitalized at the largest third-level reference institution for COVID-19 care in Mexico between March and April 2020. Demographic information, comorbidities, clinical and laboratory data, dates of invasive mechanical ventilation (IMV) and hospitalization, mechanical-ventilator settings and use of vasoactive drugs were recorded. RESULTS: Of 99 patients studied, 58 developed AKI (58.6%). The risk factors for AKI were older age (OR = 1.07, 95% CI = 1.01-1.13, p = 0.024); obesity (OR = 6.58, 95% CI = 1.8-24.05, p = 0.040); and the need for IMV (OR = 6.18, CI = 1.29-29.58, p = 0.023). The risk factors for mortality were obesity (OR = 5.57, 95% CI = 1.48-20.93, p = 0.011); requirement of vasoactive drugs on admission (OR = 5.35, 95% CI = 1.16-24.61, p = 0.031); and AKI (OR = 8.61, 95% CI = 2.24-33.1, p = 0.002). In-hospital mortality was significantly higher in patients with AKI stage 3 (79.3%) and AKI stage 2 (68.7%) compared with those with AKI stage 1 (25%; p = 0.004). Fifty-three patients underwent the furosemide stress test (FST) to predict progression to AKI stage 3. Of those, 12 progressed to AKI stage 3 (22%). The ROC curve for the FST had an AUC of 0.681 (p = 0.009); a sensitivity of 81.6% and a specificity of 54.5%. CONCLUSIONS: AKI was common in our cohort of patients with severe pneumonia caused by SARS-CoV-2 infection. The risk factors for AKI were older age, obesity and the need for of IMV on admission. The risk factors for mortality were obesity, requirement of vasoactive drugs on admission and AKI. Mortality was more frequent in patients with AKI stages 2-3. The FST had an acceptable predictive capacity to identify patients progressing to AKI stage 3.
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Lesión Renal Aguda/virología , COVID-19/complicaciones , Lesión Renal Aguda/epidemiología , Lesión Renal Aguda/mortalidad , Biomarcadores/metabolismo , COVID-19/epidemiología , Femenino , Furosemida , Humanos , Inflamación/complicaciones , Estimación de Kaplan-Meier , Masculino , México/epidemiología , Persona de Mediana Edad , Curva ROC , Factores de Riesgo , SARS-CoV-2/fisiologíaRESUMEN
The open access (OA) publishing, where a reader- pays economy has been replaced by an author-pays model, began at the end of the 20th century. This movement arose as an attempt to avoid excessive costs and copyright transfer agreements inherent to the subscription model.
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Publicación de Acceso Abierto/ética , Publicaciones Periódicas como Asunto/ética , Mala Conducta CientíficaRESUMEN
OBJECTIVE: Determine the proportion of patients achieving target serum urate (SU), defined as < 6 mg/dl for patients with non-severe gout and < 5 mg/dl for patients with severe gout, as well as the proportion of patients achieving remission after 5 years of followup. METHODS: Patients from the Gout Study Group (GRESGO) cohort were evaluated at 6-month intervals. Demographic and clinical data were obtained at baseline. Visits included assessments of serum urate, flares, tophus burden, health-related quality of life using the EQ-5D, activity limitations using the Health Assessment Questionnaire adapted for gout, and pain level and patient's global assessment using visual analog scales. Treatment for gout and associated diseases was prescribed according to guidelines and available drugs. RESULTS: Of 500 patients studied, 221 had severe gout (44%) and 279 had non-severe gout (56%) at baseline. No significant differences were observed across the study in percentages of severe gout versus non-severe gout patients achieving SU 6 mg/dl or 5 mg/dl. The highest proportion of patients achieving target SU (50-70%) and remission (39%) were found after 3-4 years of followup. In the fifth year, these proportions decreased and 28% of the patients were in remission, but only 40 patients remained in the study. None of the patients with severe gout achieved remission. CONCLUSION: In patients with severe gout, target SU was hard to achieve and remission was not possible. The main obstacles for target SU and gout remission include poor medication adherence, persistent tophi, and loss to followup.
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Supresores de la Gota/uso terapéutico , Gota/sangre , Gota/tratamiento farmacológico , Índice de Severidad de la Enfermedad , Ácido Úrico/sangre , Adulto , Femenino , Estudios de Seguimiento , Gota/epidemiología , Encuestas Epidemiológicas , Humanos , Estudios Longitudinales , Masculino , Cumplimiento de la Medicación , México/epidemiología , Persona de Mediana Edad , Estudios Prospectivos , Calidad de Vida , Inducción de Remisión , Resultado del Tratamiento , Escala Visual Analógica , Adulto JovenRESUMEN
Abstract: Objective: To determine the prevalence and risk factors for oral high-risk human papillomavirus (HR-HPV) infection in human immunodeficiency virus(HIV)-infected men. Materials and methods: Consecutive male outpatients with HIV-infection were enrolled. Demographic and behavioral risk data were obtained. Anal swabs and oral rinses were tested for HR-HPV DNA. Oral, pharyngeal and video laryngoscopy examinations were performed for detection of lesions. Results: The prevalence of HR-HPV oral infection was 9.3% (subtypes other than HR HPV 16/18 predominated). The prevalence of anal HR-HPV infection was 75.7%. The risk factors for oral infection with HR-HPV were tonsillectomy (OR=13.12) and years from HIV diagnosis (OR=1.17). Conclusions: Tonsillectomy and years from HIV diagnosis were associated with oral HPV infection. No association was found between oral and anal HR-HPV infections. This is the first study reporting the prevalence and risk factors for oral HR-HPV infection in Mexican HIV-infected population.
Resumen: Objetivo: Determinar la prevalencia y los factores de riesgo para infección oral por virus de papiloma humano de alto riesgo (VPH-AR) en individuos con VIH. Material y métodos: Se incluyeron pacientes ambulatorios consecutivos con VIH. Se recabó información demográfica y sobre factores de riesgo conductuales. Se detectó DNA de VPH-AR en hisopado rectal y enjuague bucal. Se efectuó exploración de boca, faringe y videolaringoscopía para detectar lesiones. Resultados: La prevalencia de VPH-AR oral fue 9.3% (predominaron subtipos diferentes de VPH-AR 16/18). La prevalencia de VPH-AR anal fue 75.7%. Los factores de riesgo para VPH-AR oral fueron la tonsilectomía (OR=13.12) y los años de diagnóstico del VIH (OR=1.17). Conclusiones: La tonsilectomía y los años de diagnóstico del VIH se asociaron con VPH-AR oral. No hubo asociación entre VPH-AR oral y anal. Este es el primer reporte sobre prevalencia y factores de riesgo para VPH-AR oral en población mexicana con VIH.