PURPOSE: The aim of the study was to assess differences in health-related quality of life (HRQoL) in HIV-infected naive patients treated with two HAART regimens at 12 months. METHOD: The MOS-HIV questionnaire was used to measure HRQoL in a subgroup of 127 patients included in the COMBINE study, which was an open-label, randomized, multicenter study comparing zidovudine (ZDV) and lamivudine (3TC) plus nelfinavir (NFV) or nevirapine (NVP) regimens in HIV-infected naive patients. 63 patients were included in the ZDV/3TC/NFV arm and 64 in the ZDV/3TC/NVP arm. RESULTS: No statistically significant differences were observed at baseline in demographic and clinical variables and HRQoL scores between treatment groups, except that the proportion of homosexual men was higher in the ZDV/3TC/NVP arm. There were no statistically significant differences in HRQoL scores between arms at 12 months and over time; only ZDV/3TC/NVP patients showed statistically significant improvement in Physical Health Summary score (p <.01) and a trend toward a better profile in Mental Health Summary score (p =.07). Overall, patients who were treated with ZDV/3TC/NVP showed greater changes in physical dimensions and patients who were treated with ZDV/3TC/NFV showed greater changes in mental health. CONCLUSION: Differences in HRQoL between study groups at 1 year follow-up were not detected. Nevertheless, a trend toward improvement was observed in summary health scores in ZDV/3TC/NVP-treated patients.

Adult↗

PubMedDate not supplied

Chronic fatigue syndrome: studies on skeletal muscle.

Chronic fatigue syndrome represents a poorly defined disease with protean clinical manifestations, the majority of them expressed as a muscle fatigue or as inability to maintain the expected muscle strength. In the present work we studied muscle function and muscle histopathology in 20 patients fulfilling the proposed criteria for chronic fatigue syndrome. Special interest is directed towards the immunoreactive expression of class I MHC molecules comparing some inflammatory and virus-related myopathies with muscles from chronic fatigue syndrome. Only minor morphological changes were detected in 9 out of 20 patients of the series. The nonspecific morphological changes in muscle tissue and the lack of class I MHC expression does not support the viral etiology of muscle fatigue in chronic fatigue syndrome. In contrast with the reported clinical improvement with high doses of essential fatty acids, our patients' clinical condition did not improve after three months of L-carnitine therapy.

Adolescent↗

PubMedDate not supplied

Idiopathic inflammatory myopathies. Immunohistochemical analysis of the major histocompatibility complex antigen expression, inflammatory infiltrate phenotype and activation cell markers.

Muscle biopsies from 21 dermatomyositis (DM) and 7 polymyositis (PM) patients were studied by conventional histoenzymatic reactions and immunoreacted with antibodies against T cells and subsets, B cells, macrophages, activated T cells, proliferating cells, transferrin and IL-2 receptors, and natural killer cells. The expression of both class I and II molecules from the major histocompatibility complex (MHC) was also tested. As control groups we used muscle biopsies from normal healthy people, from chronic alcoholics and from a cohort of HIV-1 infected patients. In DM cases, severe muscle fiber necrosis, predominant perivascular infiltrates, fibrosis and perifascicular atrophy were the rule whereas in PM cases, endomysial infiltrates and the existence of partially invaded non-necrotic cells were more frequent. Perivascular B cells were found only in some DM cases. Transferrin and IL-2 receptors, proliferating cells and NK cells were detected in some cases from both diseases. MHC class I molecules were detected mainly in perifascicular fibres in DM while in PM the stronger expression was demonstrated in non-necrotic partially invaded cells, suggesting for the latter a MHC-restricted T-cell cytotoxicity. MHC Class II molecules expression in endothelial cells was detected in a variable fashion in both diseases, probably reflecting different stages of activation of such cells.

Case-Control Studies↗

PubMedDate not supplied

[Sweet's syndrome associated with mesenteric lipodystrophy and a myelodysplastic syndrome].

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Aged↗

PubMedDate not supplied

Symptomatic myopathies in HIV-1 infected patients untreated with antiretroviral agents--a clinico-pathological study of 30 consecutive patients.

OBJECTIVE: To assess the clinico-pathological profile of symptomatic myopathies developing in HIV-1 infected patients before use of any antiretroviral therapy. DESIGN: Prospective, cross-sectional study. SETTING: University-referral, tertiary care Hospital. PATIENTS: Thirty consecutively admitted, HIV-1 infected patients untreated with antiretrovirals and with clinically suspected skeletal myopathy or raised serum creatinkinase levels. INTERVENTIONS: Clinical assessment of muscle strength and open muscle biopsy regarding to histopathological features. RESULTS: Most of the HIV-1 infected patients were weaker when compared to the matched healthy control group. Only a few patients presented with myalgia. In one third of the cases an inflammatory condition (microvasculitis, myositis) was evident. In another third minor myopathic changes were observed, while in the remaining cases muscle biopsy was normal. Abnormal values of CK correlated poorly with pathologic diagnosis. CONCLUSIONS: In a significant proportion of HIV-1 infected symptomatic patients a specific treatment can be given when the existence of an inflammatory condition is diagnosed by muscle biopsy.

Acquired Immunodeficiency Syndrome↗