Subject(s)
Brain Diseases/diagnostic imaging , Calcinosis/diagnostic imaging , Lupus Erythematosus, Systemic/diagnostic imaging , Tomography, X-Ray Computed , Basal Ganglia/diagnostic imaging , Brain Diseases/etiology , Calcinosis/etiology , Cerebellar Nuclei/diagnostic imaging , Female , Humans , Internal Capsule/diagnostic imaging , Lupus Erythematosus, Systemic/complications , Middle Aged , Syncope/etiologyABSTRACT
No disponible
Subject(s)
Humans , Community-Acquired Infections/drug therapy , Pneumonia/drug therapy , Clinical Protocols , Impacts of Polution on HealthSubject(s)
Anti-Bacterial Agents/therapeutic use , Community-Acquired Infections/drug therapy , Diagnostic Tests, Routine/statistics & numerical data , Disease Management , Pneumonia, Bacterial/drug therapy , Aged , Aged, 80 and over , Anti-Bacterial Agents/economics , Community-Acquired Infections/economics , Community-Acquired Infections/epidemiology , Comorbidity , Diabetes Mellitus/epidemiology , Diagnostic Tests, Routine/economics , Female , Health Expenditures/statistics & numerical data , Humans , Male , Middle Aged , Patient Admission/statistics & numerical data , Pneumonia, Bacterial/economics , Pneumonia, Bacterial/epidemiology , Program Evaluation , Pulmonary Disease, Chronic Obstructive/epidemiology , Retrospective Studies , Risk Factors , Smoking/epidemiology , Unnecessary Procedures/economicsABSTRACT
BACKGROUND: We analyzed differences in response to combined antiretroviral therapy (cART) according to sex and geographic origin in a retrospective comparative study of Spanish-born and immigrant patients initiating cART. METHODS: The primary endpoint was time to treatment failure (TTF), defined as virological failure, death, opportunistic infection, interruption of cART, or loss to follow-up. Late diagnosis was defined as a CD4+ cell count ≤ 200 cells/mm3 and/or AIDS at initiation of cART. Survival was analyzed using Kaplan-Meier analysis and Cox regression. RESULTS: We followed 1,090 patients, of whom 318 were women (45.6% immigrant women [IW]). At initiation of treatment, women had a higher CD4+ count than men (217 vs 190 cells/mm3), a lower viral load (4.7 vs 5 log), and fewer were late starters (49% vs 59%). The adjusted risk of TTF between women and men was not significantly different (hazard ratio [HR], 1.10; 95% CI, 0.79-1.53). TTF was shorter among IW than Spanish-born women (124 weeks [95% CI, 64-183] vs 151 [95% CI, 127-174]) and loss to follow-up was double that of Spanish-born women (25.5% vs 11.6%). CONCLUSIONS: Although response to cART was similar for both sexes, men started treatment later. IW were more frequently lost to follow-up and switched treatment. Measures to improve medical follow-up after initiation of cART should be promoted among this minority group.
Subject(s)
Anti-HIV Agents/administration & dosage , HIV Infections/drug therapy , Adult , CD4 Lymphocyte Count , Cohort Studies , Drug Therapy, Combination , Emigrants and Immigrants , Female , HIV Infections/immunology , HIV Infections/mortality , HIV Infections/virology , Humans , Male , Proportional Hazards Models , Retrospective Studies , Sex Characteristics , Spain , Time Factors , Treatment FailureABSTRACT
El Síndrome de Budd Chiari se caracteriza por la obstrucción del retorno venoso de los venas hepáticas, la vena cava inferior o la aurícula derecha. El presente caso ilustra el índice de sospecha clínica necesario para el diagnóstico precoz del Síndrome de Budd Chiari cuando las pruebas complementarias iniciales (transaminasasas y ECO Abdominal) no son concluyentes (AU)
Budd Chiari Syndrome is characterised by the obstruction of venous return of the hepatic veins, the inferior vena cava and the right atrium. This case illustrates the index of clinical suspicion necessary for early diagnosis of Budd Chari Syndrome when initial complementary tests (transaminases and abdominal ultrasound) are not conclusive (AU)
Subject(s)
Humans , Female , Adult , Budd-Chiari Syndrome/diagnosis , Budd-Chiari Syndrome/therapy , Early Diagnosis , Venous Thrombosis/complications , Contraceptives, Oral/adverse effects , Phlebography , Budd-Chiari Syndrome/chemically induced , Budd-Chiari Syndrome/physiopathology , Budd-Chiari Syndrome , Phlebography/instrumentation , Phlebography/methods , Ultrasonography, DopplerABSTRACT
El tabaquismo es el factor de riesgo cardiovascular modificable más importante. El bupropión es el método de deshabituación tabáquica (DT) más eficaz, pero se metaboliza por el citocromo P-450 y podría provocar interacciones con los antirretrovirales. Presentamos un estudio prospectivo de DT con bupropión en pacientes VIH1 en tratamiento antirretroviral. Se incluyeron 21 pacientes. El 38% seguían sin fumar al año. No se encontraron interacciones clínicamente significativas. La DT con bupropión es efectiva y no ha provocado interacciones clínicamente significativas con los antirretrovirales (AU)
Smoking is the most important modifiable cardiovascular risk factor. Bupropion administration is an effective method to achieve smoking cessation (SC), but the drug is metabolized by the cytochrome P450 enzyme system and this might cause interactions with antiretroviral drugs. We present a prospective study of bupropion SC therapy in HIV-positive patients under antiretroviral treatment. A total of 21 patients were studied; 38% of them stopped smoking for more than one year. No clinically significant drug interactions were found. Bupropion SC therapy was effective in HIV-positive patients and did not cause significant clinical interactions with antiretroviral drugs (AU)
Subject(s)
Humans , Tobacco Use Disorder/drug therapy , Tobacco Use Cessation/methods , Bupropion/pharmacokinetics , HIV Infections , Anti-Retroviral Agents/pharmacokinetics , Drug Interactions , Prospective StudiesABSTRACT
Smoking is the most important modifiable cardiovascular risk factor. Bupropion administration is an effective method to achieve smoking cessation (SC), but the drug is metabolized by the cytochrome P450 enzyme system and this might cause interactions with antiretroviral drugs. We present a prospective study of bupropion SC therapy in HIV-positive patients under antiretroviral treatment. A total of 21 patients were studied; 38% of them stopped smoking for more than one year. No clinically significant drug interactions were found. Bupropion SC therapy was effective in HIV-positive patients and did not cause significant clinical interactions with antiretroviral drugs.
Subject(s)
Anti-Retroviral Agents/therapeutic use , Bupropion/therapeutic use , Dopamine Uptake Inhibitors/therapeutic use , HIV Seropositivity/drug therapy , Smoking Cessation , Smoking/drug therapy , Adult , Drug Interactions , Female , Humans , Male , Prospective StudiesABSTRACT
No disponible
