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J Gómez-Rodrigo

Publications and source records attributed to J Gómez-Rodrigo.

6 recordsLinked to original sources
PubMed2001

[Fever of unknown origin in HIV positive patients].

OBJECTIVES: To describe the clinical presentation of FUO in patients infected with HIV and to asses the diagnostic usefulness in this population of several test usually recommended in the study of FUO. PATIENTS AND METHODS: We studied the clinical charts of all patients with HIV that required admission to our Hospital during a 23-month period. FUO was defined according to Petersdorf's modified criteria. Fifty-four patients fulfilled study criteria during the entry period. RESULTS: A cause of fever was identified for 48 patients (89%). Tuberculosis, disseminated atypical mycobacteriosis and Leishmaniasis can explain 68% of them. Examination of bone marrow aspirates, lymph node aspirates and biopsy, and culture of clinical specimens for mycobacteria were the procedures with the highest diagnostic yield. CONCLUSIONS: Mycobacterial infection should be considered as a first-line diagnosis in HIV-patients with FUO. It is possible to predict the diagnosis of tuberculosis infection with a high level of confidence (90.5%) through a logistic regression model based on easily obtainable parameters.

AIDS-Related Opportunistic Infections↗
PubMed2000

[Changes in the profile of HIV-positive patients. What has happened in the last 5 years?].

OBJECTIVE: To evaluate possible changes in the social, cultural and economical profile of our HIV infected patients appearing during the last five years and their potential impact on incidence, prevention, and follow-up of HIV infection. METHODS: We conduce a retrospective analysis of demographic, sociocultural, clinical and therapeutic characteristics of two groups of HIV infected patients reaching for the first time a level of 300 CD4 or less either in 1992 or in 1997. RESULTS: 55 patients with a mean age of 33 years (68% male 32% female) were studied. No differences were found in sexual behavior, HIV status of sexual partner, cultural level, risk practice, VHB or YHC seroprevalence. Attempts al drug quitting in 1992 were made individually and through institutional programs in 1997. Significant differences were found in the number of visits to the outpatient clinic the previous 36 months, and in de number of drugs (1.5 versus 3.5 P < 0.0001). Antirretroviral drugs were use in 62% of our 1992 patients and in 86% of the 1997 group (p < -0.02). CONCLUSIONS: The sociocultural and demographic profile has not changed in our environment in the last five years. However patients were identified later and followed less regularly at our clinic five years ago. Institutional methadone programs are the method or choice in our current patients for stopping illicit drug use. Finally treatment intensity has dramatically increased in our patients parallel to the growing therapeutical arsenal in this field.

Adult↗
PubMed1999

Treatment of visceral leishmaniasis in HIV-infected patients: a randomized trial comparing meglumine antimoniate with amphotericin B. Spanish HIV-Leishmania Study Group.

BACKGROUND: Visceral leishmaniasis is common in patients with HIV infection living in endemic areas, but the most effective and safe treatment remains unknown. OBJECTIVE: To compare the efficacy and safety of meglumine antimoniate versus amphotericin B in HIV-infected patients with first episodes of visceral leishmaniasis (VL). DESIGN: An open, multicentre, prospective and randomized trial. SETTING: Twelve tertiary hospitals. PATIENTS: Eighty-nine consecutive HIV-infected patients diagnosed with VL. Patients were randomly assigned to treatment with either meglumine antimoniate (20 mg pentavalent antimony per kilogram of body weight per day) or amphotericin B (0.7 mg/kg per day) both for 28 days. Treatment was considered successful if a bone marrow aspirate performed 1 month after the end of therapy did not detect parasites. Relapse was defined as the reappearance of parasites after an initial cure. RESULTS: An initial cure was attained in 29 of 44 patients (65.9%) randomly assigned to treatment with meglumine antimoniate and 28 of 45 (62.2%) randomly assigned to treatment with amphotericin B. The incidence of moderate to severe adverse events was similar in both groups. The patients treated with meglumine antimoniate had higher incidences of cardiotoxicity (14 versus 0%, P = 0.02) and chemical pancreatitis (30 versus 0%, P < 0.01). However, in the amphotericin B group, nephrotoxicity was more frequent (36 versus 5%, P < 0.01). There was no difference in survival or relapse-free interval according to the allocated group of therapy. CONCLUSION: Treatment of VL with meglumine antimoniate or amphotericin B was shown to have similar efficacy and toxicity rates in Spanish HIV-infected patients. The differences in the toxicity patterns could be useful in choosing one of these agents as first-line treatment.

AIDS-Related Opportunistic Infections↗
PubMed1988

High prevalence of tuberculosis in AIDS patients in Spain.

A total of 67 cases of tuberculosis was diagnosed in the first 100 cases of AIDS, diagnosed according to the former CDC criteria, at a hospital in Madrid, Spain. This is the highest known prevalence of tuberculosis in AIDS patients both within and outside Spain. The clinical manifestations of tuberculosis were very variable and atypical. The rate of isolation of Mycobacterium tuberculosis from blood was particularly high: of 25 patients in whom blood cultures were performed, 16 were positive. In a third of the patients with proven mycobacteremia, blood was the first or the only positive specimen. In general, therapy resulted in rapid clinical improvement, but in some cases mycobacteria were isolated from clinical or necroscopy specimens months after what was considered adequate therapy.

Acquired Immunodeficiency Syndrome↗