[Sex influence in lipodystrophy of HIV-infected patients and its association with cardiovascular risk factors]. / Impacto del sexo en el síndrome de lipodistrofia en pacientes con infección por el VIH y su asociación con factores de riesgo cardiovascular.

OBJECTIVE: To evaluate the influence of sex in human immunodeficiency virus (HIV)-infected patients with lipodystrophy and its association with cardiovascular risk factors. PATIENTS AND METHOD: A cross-sectional study was conducted in HIV-infected patients aged 20 or over managed at the outpatient Infectious Disease Unit in 2003. Clinical and epidemiological characteristics of HIV infection, lipodystrophy and cardiovascular risk factors were evaluated. RESULTS: Of the 760 patients included in the study, women comprised 28%. Men with lipodystrophy had a higher prevalence of hypertension, hypercholesterolemia, hypoalphalipoproteinemia and hypertriglyceridemia than those without lipodystrophy. Women with lipodystrophy had a higher prevalence of central obesity and hypertriglyceridemia compared with those without lipodystrophy (22.8 vs. 11.2%, p = 0.000; 20.6 vs. 9.3%, p = 0.001; 39.7 vs. 30%, p = 0.03 y 56.6 vs. 40.9%, p = 0.0001, respectively). The lipoatrophy pattern was predominant in men (24.9 vs. 12.6%, p = 0.0001) and lipoaccumulation forms in women (12.3 vs. 22.6%, p = 0.0001). Furthermore, women were younger, had a higher prevalence of smoking, family history of premature coronary heart disease and central obesity, and a lower prevalence of hypertension and hypoalphalipoproteinemia than men with lipodystrophy (42.1 +/- 8 years vs. 44.8 +/- 9.9 years, p = 0.03; 77.5 vs. 64%, p = 0.04; 22.5 vs. 9%, p = 0.003; 31 vs. 8.5%, p = 0.0001; 9.9 vs. 22.8%, p = 0.01; 25.4 vs. 39.7%, p = 0.03). CONCLUSIONS: This study demonstrated that the influence of sex in lipodystrophy in HIV-infected patients affects not only the lipodystrophy pattern, but also the cardiovascular risk profile.

Impacto del sexo en el síndrome de lipodistrofia en pacientes con infección por el VIH y su asociación con factores de riesgo cardiovascular / Sex influence in lipodystrophy of HIV-infected patients and its association with cardiovascular risk factors

Objetivo: Evaluar el impacto del sexo en la presencia del síndrome de lipodistrofia en una población de pacientes infectados por el VIH y su asociación con los factores de riesgo cardiovascular. Pacientes y método: Estudio transversal que incluyó a los pacientes de 20 años de edad o mayores, con infección por el VIH atendidos en la consulta externa del Servicio de Medicina Interna y Enfermedades Infecciosas del Hospital del Mar de Barcelona durante el año 2.003. Se evaluaron las características clínico-epidemiológicas de la infección por el VIH, la presencia de lipodistrofía y los factores de riesgo cardiovascular. Resultados: De los 710 pacientes incluidos en el estudio, las mujeres representaban el 28% de la serie. Los varones con lipodistrofia presentaron una mayor prevalencia de hipertensión arterial, hipercolesterolemia, hipoalfalipoproteinemia e hipertrigliceridemia comparado con los que no presentaban lipodistrofia (22,8 vs. 11,2%, p = 0,000; 20,6 vs. 9,3%, p = 0,001; 39,7 vs. 30%, p = 0,03 y 56,6 vs. 40,9%, p = 0,0001, respectivamente). En las mujeres, la presencia de lipodistrofia se acompañó de una mayor prevalencia de obesidad central e hipertrigliceridemia con respecto a la ausencia de lipodistrofia. En los varones predominó el patrón de lipoatrofia (24,9 vs. 12,6%, p = 0,0001), y en las mujeres el lipoacúmulo (12,3 vs. 22,6%, p = 0,0001). Además, las mujeres eran más jóvenes, tenían una mayor prevalencia de tabaquismo, antecedentes familiares de cardiopatía isquémica prematura y de obesidad central, y una menor prevalencia de hipertensión arterial y de hipoalfalipoproteinemia que los varones con lipodistrofia (42,1 ± 8 años vs. 44,8 ± 9,9 años, p = 0,03; 77,5 vs. 64%, p = 0,04; 22,5 vs. 9%, p = 0,003; 31 vs. 8,5%, p = 0,0001; 9,9 vs. 22,8%, p = 0,01; 25,4 vs. 39,7%, p = 0,03, respectivamente). Conclusiones: El presente estudio demuestra que el impacto del sexo en la lipodistrofia de los pacientes con infección por el VIH no sólo afecta al patrón de lipodistrofia, sino también al perfil de riesgo cardiovascular

Objective: To evaluate the influence of sex in human immunodeficiency virus (HIV)-infected patients with lipodystrophy and its association with cardiovascular risk factors. Patients and method: A cross-sectional study was conducted in HIVinfected patients aged 20 or over managed at the outpatient Infectious Disease Unit in 2003. Clinical and epidemiological characteristics of HIV infection, lipodystrophy and cardiovascular risk factors were evaluated. Results: Of the 760 patients included in the study, women comprised 28%. Men with lipodystrophy had a higher prevalence of hypertension, hypercholesterolemia, hypoalphalipoproteinemia and hypertriglyceridemia than those without lipodystrophy. Women with lipodystrophy had a higher prevalence of central obesity and hypertriglyceridemia compared with those without lipodystrophy (22.8 vs. 11.2%, p = 0.000; 20.6 vs. 9.3%, p = 0.001; 39.7 vs. 30%, p = 0.03 y 56.6 vs. 40.9%, p = 0.0001, respectively). The lipoatrophy pattern was predominant in men (24.9 vs. 12.6%, p = 0.0001) and lipoaccumulation forms in women (12.3 vs. 22.6%, p = 0.0001). Furthermore, women were younger, had a higher prevalence of smoking, family history of premature coronary heart disease and central obesity, and a lower prevalence of hypertension and hypoalphalipoproteinemia than men with lipodystrophy (42.1 ± 8 years vs. 44.8 ± 9.9 years, p = 0.03; 77.5 vs. 64%, p = 0.04; 22.5 vs. 9%, p = 0.003; 31 vs. 8.5%, p = 0.0001; 9.9 vs. 22.8%, p = 0.01; 25.4 vs. 39.7%, p = 0.03). Conclusions: This study demonstrated that the influence of sex in lipodystrophy in HIV-infected patients affects not only the lipodystrophy pattern, but also the cardiovascular risk profile

Artritis séptica aguda por Candida albicans en una paciente con infección por virus de la inmunodeficiencia humana / Candida albicans acute septic arthritis in a patient with human immunodeficiency virus infection

No disponible

Alteraciones óseas y del metabolismo mineral en la infección por el virus de la inmunodeficiencia humana / Bone and mineral metabolism disorders in human inmunodeficiency virus infection

No disponible

[Animal bites. Study of 606 cases]. / Mordedura por animales. Estudio de 606 casos.

BACKGROUND: There is scarce information on animal bites in Spain. The objective of this study was to know the incidence, characteristics of the bitten persons, characteristics of biting animals, location of wounds and therapeutic behavior in our environment. PATIENTS AND METHODS: Descriptive study of patients who visited a rabies service after having been bitten by animals. STUDY PERIOD: from March, 1st, 1995, to February, 29th, 1996. During the study period 606 patients were visited and 2,400 telephone consultations answered. RESULTS: The incidence was 100 animal bites per 100,000 inhabitants/year. The male/female distribution of attended patients was 347/251 (47.3 vs 42.7%, respectively), a mean age of 32.5 +/- 21 years; 25% of cases were aged less than 15 years. The offending animals were: dogs 450 (74.3%), cats 97 (16%), rats 32 (5.3%), hamsters 16 (2.6%) and other animals 11 (1.8%). In 52.8% of cases the offending animals were owned by the bitten persons or domestic; in children 64.2% of cases were animals with these characteristics (p < 0.007); in this group of patients the rabies vaccination was correct in 61% of dogs and 40% of cats. The hand was the most frequent location of the wound, although face and neck locations were not uncommon in children (13.2%) compared with adults (4.4%) (p < 0.0002). The therapeutic behavior includes antitetanic prophylaxis in virtually all cases; antibiotic therapy was inappropriate in 44.4 of cases; a correct diversion towards the rabies service occurred in 42.4% of cases. The post-exposition rabies vaccine was administered in 218 patients, with a rate of 7.3/100,000 inhabitants/year. CONCLUSIONS: In the Barcelona province area animal bites are relatively common; in general populations preventive measures and health education are required, particularly among domestic animal owners, as well as health care personnel on the proper behavior when faced with animal bites.

[Fiber optics bronchoscopy yield and predictive clinical, analytical, and radiologic factors in the etiologic diagnosis of pulmonary pathology in patients with HIV infection]. / Rendimiento de la fibrobroncoscopia y factores predictivos clínicos, analíticos y radiológicos en el diagnóstico etiológico de la patología pulmonar en pacientes con infección por VIH.

UNLABELLED: The aim of this study was to assess the diagnostic performance of fibrobronchoscopy (FBS) in the pulmonary pathology of HIV-positive patients, in order to study the effect of several factors on such performance and to evaluate if these factors could guide the etiologic diagnosis. A retrospective study of 49 FBS with bronchoalveolar lavage (BAL) was performed in 44 HIV-positive patients. The diagnostic performance of FBS with BAL was 71.4%, with no significant modifications caused by previous prophylactic or empirical therapies, time of clinical evolution, radiological pattern, presence of hypoxemia or CD4 count. On the contrary, a high LDH was associated to a higher diagnostic performance. DIAGNOSIS: Pneumonia by Pneumocystis carinii (36.7%), M. tuberculosis (28.6%) and bacterial pneumonias (16.3%). The presence of biliary adenopathies, evolution longer than 1 week and pO2 > 80 mm Hg had a high sensitivity of 28.5% and a specificity of 97% for the diagnosis of tuberculosis, with a positive predictive value of 80% and a negative predictive value of 77.7%.