[Progressive multifocal leucoencephalopathy in AIDS patients. Hepatotoxicity of HAART in patients with hepatitis B or C]. / Leucoencefalopatía multifocal progresiva en pacientes con sida. Hepatotoxicidad de la terapia de alta eficacia (TARGA) en pacientes con coinfección por VHB o VHC.

Progressive multifocal leukoencephalopathy (PML) develops in 1-8% of patients with AIDS, for which it is a disease-defining condition. PML presents mainly in severely immunocompromised male intravenous drug users, having viral loads greater than log5 RNA copies/mL and CD4 populations lower than 150 cells/mm3. Death of AIDS patients with PML occurred after only 4 to 6 months before the introduction of highly active antiretroviral therapies (HAART), the only ones that have shown to prolong survival. Viral hepatitis is not the only liver condition affecting patients with AIDS, opportunistic infections and neoplasms, such as lymphoma and Kaposi's sarcoma, as well as biliary disease are also encountered but, fortunately, they are currently less frequent as a result of the new antiretroviral treatments. The risks of HAART hepatotoxicity in patients with hepatitis B or C have been studied by several groups.

Leucoencefalopatía multifocal progresiva en pacientes con sida. Hepatotoxicidad de la terapia de alta eficacia (TARGA) en pacientes con coinfección por VHB o VHC / Progressive multifocal leucoencephalopathy in aids patients. Hepatotoxicity of hart in patients with hepatitis B or C

La leucoencefalopatía multifocal progresiva (LMP) es un criterio diagnóstico de sida. Afecta al 1-8% de los pacientes con sida (según las series), con supervivencias de 4-6 meses antes de las terapias antirretrovirales de gran actividad (TARGA). Se observa sobre todo en pacientes usuarios a drogas por vía parenteral, con inmunodeficiencia avanzada (Carga vírica: log 5 copias/ ml y CD4 < 150/ mm3). Parece que sólo los pacientes bajo tratamiento con TARGA consiguen supervivencias más prolongadas. Las hepatitis víricas no son el único problema que se ha visto en pacientes con infección por VIH. Infecciones oportunistas y neoplasias, tales como el linfoma y sarcoma de Kaposi y problemas biliares han sido observados, si bien estos no son muy frecuentes, gracias a los nuevos tratamientos antirretrovirales. Sin embargo en pacientes con Hepatitis B o C el tratamiento antirretroviral puede causar mayor hepatotoxicidad

Progressive multifocal leukoencephalopathy (PML) develops in 1-8% of patients with AIDS, for which it is a disease-defining condition. PML presents mainly in severely immunocompromised male intravenous drug users, having viral loads greater than log5 RNA copies/mL and CD4 populations lower than 150 cells/mm3. Death of AIDS patients with PML occurred after only 4 to 6 months before the introduction of highly active antiretroviral therapies (HAART), the only ones that have shown to prolong survival. Viral hepatitis is not the only liver condition affecting patients with AIDS, opportunistic infections and neoplasms, such as lymphoma and Kaposi’s sarcoma, as well as biliary disease are also encountered but, fortunately, they are currently less frequent as a result of the new antiretroviral treatments. The risks of HAART hepatotoxicity in patients with hepatitis B or C have been studied by several groups

[Pseudo-obstruction chronic disease, lymphoid hyperplasia of the gastrointestinal tract and intestinal endometriosis]. / Seudoobstrucción intestinal crónica, hiperplasia nodular linfoide intestinal y endometriosis intestinal.

Nodular lymphoid hyperplasia of the gastrointestinal tract associated to endometriosis is an uncommon cause of chronic pseudo-obstruction and malabsortion. The case of a 32-year-old woman who suffered from this syndrome for one a half years is described. Diagnosis was achieved by laparotomy, which disclosed swelling and inflammation of the 30 cm terminal yeyunal portion. Removal of the involved intestine and side-to-side anastomosis were performed. The pathological findings were: follicular lymphoid hyperplasia with mucosal ulcers an fissures inflammatory pseudo-polyps, chronic deep enteritis and areas of endometriosis. A favourable outcome followed surgery.

Seudoobstrucción intestinal crónica, hiperplasia nodular linfoide intestinal y endometriosis intestinal / Pseudo-obstruction chronic disease, lymphoid hyperplasia of the gastrointestinal tract and intestinal endometriosis

La presencia de hiperplasia nodular linfoide intestinal asociada a focos de endometriosis con comportamiento clínico de seudoobstrucción intestinal crónica y síndrome de malabsorción es una entidad infrecuente. Describimos el caso de una paciente de 32 años con este síndrome de año y medio de evolución clínica. El diagnóstico etiológico se realizó mediante laparotomía. Los últimos 30 cm del íleon presentaban signos inflamatorios con engrosamiento de la pared intestinal y se practicó resección de la zona afectada y anastomosis latero-lateral. El diagnóstico anatomopatológico fue de hiperplasia linfoide folicular con úlceras y fisuras mucosas, pseudopólipos inflamatorios, enteritis crónica profunda y focos de endometriosis. La evolución clínica de la paciente fue favorable tras la cirugía (AU)

¿Tratamiento de prueba de la eosinofilia con antiparasitarios? / Test treatment with antiparasitic agents for eosinophilia?

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[Vascular risk factors in non-insulin-dependent diabetes mellitus. Correlation between albuminuria and glycosylated hemoglobin]. / Factores de riesgo vascular en la diabetes mellitus no insulinodependiente. Correlación entre albuminuria y hemoglobina glicada.

OBJECTIVE: This study compared 23 patients with non-insulin-dependent diabetes mellitus (NIDDM) and 28 non-diabetic control subjects, seeking for associations between NIDDM and other cardiovascular risk factors. The relationship of the glycemic control with the risk factor profile was also assessed. RESULTS: The most outstanding results were: The diabetic group showed higher values in the proportion of subjects with diabetes family history (P < 0.01) and the levels of systolic blood pressure (P < 0.05), total cholesterol (P < 0.05), triglyceridemia (P < 0.001), and total cholesterol to HDL cholesterol ratio (P < 0.01). Within the diabetic group, a positive correlation (r = 0.68, P < 0.001) was found between the percent of glycosylated haemoglobin (HbA1c) and the 24-hour urinary albumin excretion rate (UAER). CONCLUSION: We conclude that NIDDM associates to other cardiovascular risk factors. The correlation of HbA1c with UAER suggests a possible relationship between poor diabetic control and some of the secondary diabetic complications.

Factores de riesgo vascular en la diabetes mellitus no insulinodependiente. Correlación entre albuminuria y hemoglobina glicada / Cardiovascular risk factors in non-insulin dependent diabetes mellitus: correlation of albuminuria and glycosilates haemoglobin

Objetivo: Se estudió el perfil de presentación de diversos factores de riesgo cardiovascular en la diabetes mellitus no insulino dependiente (DMNID),. Métodos: Comparando su presencia en 23 pacientes con DMNID y 28 controles no diabéticos, así como la relación del grado de control glucémico con dichos factores. Resultados: Como resultados más destacados, se encontró en el grupo diabetico había mayor frecuencia que en el control de antecedentes familiares de diabetes (P<0,01) y mayores cifras de tensión arterial sistólica (P<0,05), colesterol total (P<0,05), trigliceridemia (P<0,001) y cociente colesterol total/colesterol HDL (P<0,01). Dentro del grupo diabético, había una correlación positiva (r=0,68; p<0,001) entre el porcentaje de hemoglobina glicada (HbAlc) y la tasa de excreción urinaria de albúmina en 24 horas (TEUA). Conclusión: Concluimos, que la DMNID se asocia a otros factores de riesgo cardiovascular. La correlación entre HbAlc y TEUA, sugiere posibles relaciones entre el mal control diabético y algunas complicaciones secundarias de la DMNID (AU)

[Brucellosis: a clinico-serological study in a rural health area]. / Brucelosis: estudio clinicoserológico en un área de salud rural.

UNLABELLED: We analyze retrospectively 132 cases of brucellosis evaluating the performance of diagnostic procedures, complications and serological and clinical evolution. We compare the 74 patients treated with streptomycin plus tetracycline versus the 41 patients treated with doxycycline plus rifampicin. The more outstanding results we find: a) Great sensibility of the rose bengal test; b) Higher relapse rate in the more severe cases (p less than 0.01); c) Good evolution with scarce relapse rate in both treatment groups; agglutination titers were lower at one year in the group treated with doxycycline plus rifampicin (p less than 0.05). CONCLUSIONS: Both treatments showed good efficacy, controlled studies would be needed to determine the most adequate one.