RESUMEN
OBJETIVES: The main objective was to compare the persistence between dolutegravir/lamivudine (DTG/3TC) and bictegravir/emtricitabine/tenofovir-alafenamide (BIC/FTC/TAF) and to analyze reasons for discontinuation. METHODS: We conducted a retrospective, non-interventional, descriptive, and longitudinal study. All human immunodeficiency virus (HIV) patients over 18â¯years treated with DTG/3TC or BIC/FTC/TAF in our center were included. Persistence after first year was compared using the χ2 test. Kaplan-Meier survival analysis was performed. RESULTS: Three hundred fifty-eight patients were included. 99.5% versus 90.99% of patients were persistent after the first year for DTG/3TC and BIC/FTC/TAF respectively (p=.001). Persistence with DGT/3TC was 1237â¯days (IC95% 1216-1258) and persistence with BIC/FTC/TAF was 986â¯days [(IC95% 950-1021); p<.001]. The difference was remained after adjusting for covariates with the cox regression model [HR=8.2 (IC95% 1.03-64.9), p=.047]. The main reasons for discontinuation for BIC/FTC/TAF were toxicity/tolerability. CONCLUSION: In our study, patients have a high persistence. Patients on DTG/3TC treatment are more persistent compared to BIC/FTC/TAF, although BIC/FTC/TAF have worse baseline characteristics. The main reason for discontinuation of BIC/FTC/TAF is tolerability/toxicity.
Asunto(s)
Fármacos Anti-VIH , Emtricitabina , Infecciones por VIH , Compuestos Heterocíclicos con 3 Anillos , Lamivudine , Oxazinas , Piperazinas , Piridonas , Tenofovir , Humanos , Infecciones por VIH/tratamiento farmacológico , Estudios Retrospectivos , Masculino , Piridonas/uso terapéutico , Femenino , Lamivudine/uso terapéutico , Piperazinas/uso terapéutico , Oxazinas/uso terapéutico , Compuestos Heterocíclicos con 3 Anillos/uso terapéutico , Compuestos Heterocíclicos con 3 Anillos/efectos adversos , Adulto , Persona de Mediana Edad , Fármacos Anti-VIH/uso terapéutico , Emtricitabina/uso terapéutico , Tenofovir/uso terapéutico , Alanina/uso terapéutico , Alanina/análogos & derivados , Estudios Longitudinales , Combinación de Medicamentos , Amidas/uso terapéutico , Compuestos Heterocíclicos de 4 o más Anillos/uso terapéutico , Compuestos Heterocíclicos de 4 o más Anillos/efectos adversos , Adenina/análogos & derivados , Adenina/uso terapéuticoRESUMEN
OBJETIVES: The main objective was to compare the persistence between dolutegravir/lamivudine (DTG/3TC) and bictegravir/emtricitabine/tenofovir-alafenamide (BIC/FTC/TAF) and to analyze reasons for discontinuation. METHODS: We conducted a retrospective, non-interventional, descriptive and longitudinal study. All human immunodeficiency virus (HIV) patients over 18 years treated with DTG/3TC or BIC/FTC/TAF in our center were included. Persistence after first year was compared using the χ2 test. Kaplan-Meier survival analysis was performed. RESULTS: Three hundred fifty-eight patients were included. 99.5% versus 90.99% of patients were persistent after the first year for DTG/3TC and BIC/FTC/TAF respectively (pâ¯=â¯0.001). Persistence with DGT/3TC was 1,237 days (IC95% 1,216-1,258) and persistence with BIC/FTC/TAF was 986 days ([IC95% 950-1,021]; pâ¯<â¯0.001). The difference was remained after adjusting for covariates with the cox regression model (HR= 8.2 [IC95% 1.03-64.9], pâ¯=â¯0.047). The main reasons for discontinuation for BIC/FTC/TAF were toxicity/tolerability. CONCLUSION: In our study patients had a high persistence. Patients on DTG/3TC treatment were more persistent compared to BIC/FTC/TAF, although BIC/FTC/TAF have worse baseline characteristics. The main reason for discontinuation of BIC/FTC/TAF was tolerability/toxicity.
Asunto(s)
Fármacos Anti-VIH , Infecciones por VIH , Compuestos Heterocíclicos con 3 Anillos , Lamivudine , Oxazinas , Piperazinas , Piridonas , Humanos , Estudios Retrospectivos , Infecciones por VIH/tratamiento farmacológico , Masculino , Femenino , Piridonas/uso terapéutico , Lamivudine/uso terapéutico , Oxazinas/uso terapéutico , Adulto , Compuestos Heterocíclicos con 3 Anillos/uso terapéutico , Compuestos Heterocíclicos con 3 Anillos/efectos adversos , Piperazinas/uso terapéutico , Persona de Mediana Edad , Fármacos Anti-VIH/uso terapéutico , Tenofovir/uso terapéutico , Emtricitabina/uso terapéutico , Estudios Longitudinales , Alanina/uso terapéutico , Alanina/análogos & derivados , Amidas/uso terapéutico , Combinación de MedicamentosRESUMEN
No disponible
Asunto(s)
Humanos , Masculino , Adulto , Esofagitis/diagnóstico por imagen , Esofagitis/dietoterapia , Gastritis/diagnóstico por imagen , Esofagitis/patología , Gastritis/patología , Esófago/diagnóstico por imagen , Esófago/patología , Dolor en el Pecho/etiología , Tomografía Computarizada por Rayos X , Nutrición Parenteral , Endoscopía del Sistema Digestivo/métodosRESUMEN
A 43-year-old male with an uneventful history presented with fever and ingestion-triggered retrosternal chest pain of a three-day duration, which was aggravated by deep breathing and the supine position. When asked regarding the possible ingestion of a foreign body he recalled having accidentally swallowed tiny glass shards from a broken bottle.
Asunto(s)
Esofagitis , Cuerpos Extraños , Adulto , Esofagitis/inducido químicamente , Esofagitis/diagnóstico por imagen , Cuerpos Extraños/complicaciones , Cuerpos Extraños/diagnóstico por imagen , Cuerpos Extraños/cirugía , Humanos , MasculinoRESUMEN
Pneumocystis in humans is caused by a unicellular and eukaryotic organism called P. jirovecii. The overall incidence of P. jirovecii pneumonia (PCP) has decreased with the use of highly active antiretroviral therapy and the use of chemoprophylaxis with trimethroprim sulfametoxazole (TMP/SMX) in cases of immunosuppressed patients. However, approximately 85% of patients with advanced HIV infections continue to experience this disease with inadequate management. Pneumocystis infection can present with spontaneous pneumothorax in 2-6% of cases [8] which can be a potentially fatal complication. We report the case of a 32-year-old man presented with P. jirovecii pneumonia who developed cystic lesions and spontaneous bilateral pneumothorax in spite of TMP/SMX treatment. We consider it an interesting clinical case because few simultaneous bilateral pneumothorax cases have been described directly related to the PCP.
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No disponible
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Humanos , Masculino , Adulto , Derrame Pleural/complicaciones , Derrame Pleural/tratamiento farmacológico , Derrame Pleural , Sarcoidosis Pulmonar/complicaciones , Sarcoidosis Pulmonar , Quimioprevención , Diagnóstico Diferencial , Radiografía Torácica/métodos , AutoinmunidadRESUMEN
No disponible
Asunto(s)
Humanos , Femenino , Adulto , Coinfección/complicaciones , Coinfección/tratamiento farmacológico , Mycobacterium avium , Mycobacterium avium/aislamiento & purificación , Mycobacterium avium/patogenicidad , Combinación Efavirenz, Emtricitabina y Fumarato de Tenofovir Disoproxil/uso terapéutico , Linfadenitis/complicaciones , Linfadenitis/tratamiento farmacológico , Isoniazida/uso terapéutico , Rifampin/uso terapéutico , Síndrome de Inmunodeficiencia Adquirida/complicaciones , Síndrome de Inmunodeficiencia Adquirida/diagnóstico , Coinfección/diagnóstico , Antirretrovirales/uso terapéutico , Etambutol/uso terapéutico , Claritromicina/uso terapéutico , Biología Molecular/métodosRESUMEN
Fundamento y objetivo: Describir un cuadro clínico poco habitual como la tuberculosis esplénica aislada. Paciente y método: Presentamos un caso de tuberculosis esplénica aislada, una forma rara de tuberculosis extrapulmonar, en un paciente inmunocompetente, y que, como peculiaridad, comienza en forma de hipercalcemia sintomática. Resultados: Se expone ampliamente el caso clínico y los procedimientos realizados para excluir las patologías que integraron el diagnóstico diferencial. Hacemos énfasis en la utilidad de la punción aspirativa con aguja fina del bazo para la obtención de muestras microbiológicas, y el uso de la reacción en cadena de la polimerasa específica para micobacterias para confirmar el diagnóstico de esta entidad. Igualmente, de acuerdo con otros autores, optamos por un tratamiento médico inicial con antituberculostáticos, reservando la cirugía para los casos refractarios o que se compliquen con rotura esplénica espontánea. Conclusión: La hipercalcemia puede ser una forma de presentación de las enfermedades granulomatosas. La afectación aislada del bazo por micobacterias es una forma poco frecuente de tuberculosis extrapulmonar y más aún en pacientes inmunocompetentes (AU)
Background and objective: To describe an unusual clinical presentation as isolated splenic tuberculosis. Patient and methods: We report a case of isolated splenic tuberculosis, a rare form of extrapulmonary tuberculosis in an immunocompetent patient, and, as a peculiarity, debuts in the form of symptomatic hypercalcemia. Results: We deeply report the clinical case and the procedures performed to exclude other diseases. We emphasize the usefulness of fine needle aspiration of the spleen to obtain microbiological samples, and the use of specific polymerase chain reaction for mycobacterias to establish the definitive diagnosis of this entity. In agreement with other authors, we chose initial medical treatment with antituberculous drugs, reserving surgery for refractory cases or in case of spontaneous splenic rupture. Conclusion: Hypercalcemia can be a presentation of granulomatous diseases. The isolated involvement of the spleen by mycobacterias is a rare form of extrapulmonary tuberculosis and more so in immunocompetent patients (AU)
Asunto(s)
Humanos , Masculino , Anciano , Tuberculosis Esplénica/diagnóstico , Hipercalcemia/etiología , Biopsia con Aguja Fina/métodos , Reacción en Cadena de la PolimerasaRESUMEN
BACKGROUND AND OBJECTIVE: To describe an unusual clinical presentation as isolated splenic tuberculosis. PATIENT AND METHODS: We report a case of isolated splenic tuberculosis, a rare form of extrapulmonary tuberculosis in an immunocompetent patient, and, as a peculiarity, debuts in the form of symptomatic hypercalcemia. RESULTS: We deeply report the clinical case and the procedures performed to exclude other diseases. We emphasize the usefulness of fine needle aspiration of the spleen to obtain microbiological samples, and the use of specific polymerase chain reaction for mycobacterias to establish the definitive diagnosis of this entity. In agreement with other authors, we chose initial medical treatment with antituberculous drugs, reserving surgery for refractory cases or in case of spontaneous splenic rupture. CONCLUSION: Hypercalcemia can be a presentation of granulomatous diseases. The isolated involvement of the spleen by mycobacterias is a rare form of extrapulmonary tuberculosis and more so in immunocompetent patients.
Asunto(s)
Hipercalcemia/etiología , Tuberculosis Esplénica/diagnóstico , Anciano , Humanos , Masculino , Tuberculosis Esplénica/complicacionesAsunto(s)
Acidosis/inducido químicamente , Anticonvulsivantes/efectos adversos , Epilepsias Parciales/tratamiento farmacológico , Fructosa/análogos & derivados , Acidosis Tubular Renal/inducido químicamente , Anciano , Anticonvulsivantes/uso terapéutico , Hemorragia Cerebral Traumática/complicaciones , Comorbilidad , Sustitución de Medicamentos , Epilepsias Parciales/etiología , Fructosa/efectos adversos , Fructosa/uso terapéutico , Humanos , Masculino , Fenitoína/uso terapéutico , Polifarmacia , Esquizofrenia Paranoide/tratamiento farmacológico , Esquizofrenia Paranoide/etiología , TopiramatoRESUMEN
No disponible