PubMed Health⌕ Search

Biomedical subjects

J Collazos

Publications and source records attributed to J Collazos.

At least 37 records · Page 2Linked to original sources
PubMed1999

Evolution of serum beta2-microglobulin concentrations during treatment of tuberculosis patients.

A total of 36 human immunodeficiency virus-seronegative patients were studied in order to evaluate serum beta2-M levels in immunocompetent patients with tuberculosis who were receiving treatment. Six measurements of several clinical and laboratory parameters were carried out at different intervals during the 6 months of treatment. The mean serum beta2-M at presentation was 149 nmol/l and 4 patients had values above the upper normal limit. Significant decreases in the mean serum beta2-M concentration were observed in the follow-up determinations in the patients as a whole (p = 0.002), in the patients with normal (p = 0.039) and in the patients with increased beta2-M at presentation (p = 0.037). beta2-M significantly correlated with erythrocyte sedimentation rate (p = 0.002). The statistically significant decrease observed in patients with both normal and increased beta2-M values at presentation, suggests that the immunological dysfunction responsible for the increase in beta2-M involves most, if not all, patients with tuberculosis. The measurement of beta2-M in conjunction with other clinical and laboratory parameters could be helpful in evaluating the response to therapy, particularly in those patients with increased beta2-M at presentation.

Adolescent↗
PubMed1999

Muscle infections caused by Salmonella species: case report and review.

We describe a patient with salmonella pyomyositis and review 30 other cases reported during the past 4 decades. Men outnumbered women by 2.9 to 1, and the median age of the patients was 51 years. Approximately one-half the cases were caused by Salmonella enteritidis. Infected vascular aneurysms were observed in seven patients. Prior salmonella infections and local trauma or lesions were common. Diverse underlying conditions, mainly diabetes and human immunodeficiency virus infection, were present in 81% of the patients, and the psoas muscle was involved in 55% of the cases. One-third of the patients died, and relapses were common after a median time of 5 weeks (range, 4.5-27 weeks) in those who survived. Most patients had anemia, and pathogens were recovered from blood samples from two-thirds of the patients. Salmonella should be considered as a causative agent of muscle infections in the appropriate clinical setting, particularly in patients with underlying diseases or preexisting vascular aneurysms.

Aged↗
PubMed1999

Changing spectrum of HIV infection and its associated conditions in Spain: the end of the beginning?

To evaluate the natural history and the impact that different strategies have had on HIV infection and its associated conditions, a cohort of 970 patients (432 had AIDS) who had been seen over a period of 13 years were studied. The incidence of new HIV-infected patients had increased steadily since 1985, peaking in 1993 (52.9 cases/100,000 population), to significantly decrease in the subsequent years. The most common AIDS-defining illnesses (ADIs) were tuberculosis (52.3% of the patients), Pneumocystis carinii pneumonia (30%), and candidal esophagitis (28.6%). The frequency of new cases of tuberculosis per patient with ADI clearly decreased over this period (p < 0.0001), whereas that of P. carinii pneumonia decreased slowly until 1994, to fall thereafter to about half the previous levels (p = 0.005). Candidal esophagitis showed a biphasic pattern, the second peak probably due to the emergence of fluconazole resistance. The number of ADIs per patient increased from the beginning of the observation period, peaking in 1995 (1.67 ADI/patient), followed by a statistically significant decrease that, in 1997, reached the 1987 levels (1.22 ADI/patient). We conclude that the clinical spectrum of HIV infection is improving in the last years. Except for tuberculosis, prophylaxis for other ADIs, although effective, does not seem to have had a dramatic impact on occurrence. The most impressive reductions have been observed only after the introduction of antiretroviral combination therapy.

AIDS-Related Opportunistic Infections↗
PubMed1999

Hypersensitivity reactions to rifampin. Pathogenetic mechanisms, clinical manifestations, management strategies, and review of the anaphylactic-like reactions.

Many of the adverse events induced by rifampin have been considered allergic in origin. The flu-like syndrome and other hypersensitivity reactions seem to be caused by immune complexes, although their pathogenetic mechanisms are not fully elucidated. Many cases have been reported of the flu-like syndrome, thrombocytopenia, hemolytic anemia, and renal failure caused by rifampin. In almost all of the patients in whom they were sought, nonreaginic antirifampin antibodies were detected. On the other hand, anaphylactic reactions seem to be IgE-mediated. We have analyzed the 18 reported cases of anaphylactic reactions severe enough to cause marked hypotension. The interval between the onset of treatment and the anaphylactic reaction was highly variable. Most patients presented with prodromes, mainly rash, before the development of anaphylactic symptoms, and, in most cases, the reaction occurred after reexposure to rifampin. Clinical findings include a variety of symptoms, such as fever, exanthem, dyspnea, abdominal pain, and vomiting. Seven of the 9 patients in whom HIV status was known were seropositive, including the only 2 patients who died. We believe that, in case of a non-life-threatening adverse reaction caused by immune complexes, rifampin could be readministered, if necessary, at a more frequent and reduced dose, perhaps with the addition of corticosteroids. In case of anaphylactic reactions the drug should be avoided, although desensitization procedures may be useful. Certain laboratory findings may serve as a clue to predict anaphylactic reactions in patients who have experienced minor adverse events to rifampin. However, the diagnostic value of such findings is not well established and, therefore, patients with previous adverse reactions should be carefully monitored if reexposure to rifampin is essential.

Anaphylaxis↗
PubMed1999

Reversible cerebellar involvement in the idiopathic hypereosinophilic syndrome.

We report a patient with cerebellar manifestations due to the idiopathic hypereosinophilic syndrome, in whom magnetic resonance imaging (MRI) showed hyper-intense lesions in both cerebellar hemispheres. Following steroids and hydroxyurea administration, the lesions on MRI disappeared, suggesting that the pathogenetic mechanism was reversible and did not cause significant structural damage. To our knowledge, the resolution of the abnormal MRI findings have not been reported to date in the idiopathic hypereosinophilic syndrome.

Aged↗
PubMed1998

Fever of unknown origin in the setting of HIV infection: guidelines for a rational approach.

Fever of unknown origin constitutes a common problem in HIV-infected patients that, paradoxically, has received little attention in the literature. A review on this topic collecting data from different series showed that mycobacterial infections, particularly tuberculosis, were responsible for the fever in more than half of the patients. However, the relative frequencies of the different etiologies may vary substantially depending on the local prevalences of certain infections. With the notable exception of tuberculosis, which may develop at any stage of HIV infection, fever of unknown origin usually presents in patients with advanced disease when the CD4 cell count is below 100/microliter. In this overview we stress, from a practical point of view, some points to be considered in the evaluation of the HIV-infected patient who presents with fever of unknown origin, as well as the usefulness and yield of several diagnostic procedures.

AIDS-Related Opportunistic Infections↗
PubMed1998

Hospitalization parameters in patients infected with HIV: an analysis of the period 1992-1997.

The course of several hospitalization parameters of HIV-infected patients in a general hospital during the past 6 years was analyzed. There was a decrease observed in the number of non-AIDS diagnosed patients admitted during the observation period, but this decrement was noted only in the past 2 years in AIDS patients. This decline was not accounted for by a decrease in the incidence of AIDS patients seen each year, and was very probably due to the efficacy of antiretroviral combination therapy. The average length of stay of both AIDS and non-AIDS diagnosed patients decreased markedly during the first 3 years to stabilize during the remaining observation period. An analysis of the mode in which the patients were seen for the first time in the hospital (admitted from the emergency department because of complications of advanced HIV infection or attended in the outpatient clinic) revealed that, after a steady decrease from 1985 to 1995 in the relative proportion of patients hospitalized (p < 0.0001), there was an inversion of the downward trend in the past two years (p = 0.04). Most of the patients admitted during these 2 years were persons who did not know that they were infected with HIV. This observation reinforces the need for education campaigns and voluntary HIV testing which are particularly directed toward persons with high risk factors for the infection, in order to provide medical care before complications of advanced HIV infection appear.

Acquired Immunodeficiency Syndrome↗
PubMed1998

Sequential evaluation of serum adenosine deaminase in patients treated for tuberculosis.

STUDY OBJECTIVE: To delineate the course of serum adenosine deaminase (s-ADA) in patients with tuberculosis who are receiving effective therapy. SETTING: A medical ward and an outpatient clinic in a general hospital. PATIENTS: Twenty-five immunocompetent patients with pleural or pulmonary tuberculosis. INTERVENTIONS: All patients received standard chemotherapeutic regimens with isoniazid, rifampin, and pyrazinamide. MEASUREMENTS AND RESULTS: Six measurements of several variables, including s-ADA, were carried out at different periods of time during the 6 months of follow-up. There were no significant differences in s-ADA values between sexes and there was no significant correlation with age or with the other variables analyzed. There was a significant decline in the s-ADA values during the first 2 months in the patients as a whole (p=0.04), followed by a stabilization of the s-ADA activity. This decline was due to a marked decrease in the s-ADA in the 13 patients (52%) who had initial high levels of the enzyme (p=0.03), whereas there were no changes in those patients with normal initial levels (p=0.27). Patients with increased s-ADA activity at the time of the first measurement reported symptoms for a longer period than patients with normal s-ADA (median, 15 vs 10 days; p=0.02). CONCLUSIONS: s-ADA levels in patients with tuberculosis decrease during the initial months of effective treatment. Perhaps this decrease might reflect the normalization of the altered lymphocyte turnover induced by tuberculosis. The measurement of s-ADA could be of some help to evaluate the response to therapy, particularly in those patients with increased values of the enzyme.

Adenosine Deaminase↗