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Biomedical subjects

J M Kindelan

Publications and source records attributed to J M Kindelan.

15 recordsLinked to original sources
PubMed1998

[Diagnosis and treatment of mycobacterial infections in patients with HIV/AIDS].

Mycobacterial infection remains as a frequent complication associated to HIV infection. Although the widespread use of HAART has intensely decreased incidence of disseminated Mycobacterium avium (MAC) infection, it does not seem that it has affected tuberculosis occurrence so intensely. In spite of the intense search of new methods of rapid diagnosis, in the clinical practice the diagnosis of the mycobacterial illnesses continues based on culture, although the appearance of new media has allowed to shorten the time of growth. The combination of isoniazid (INH), rifampin (RIF) and pirazinamide (PZ) (with ethambutol [ETB] when primary resistance to INH is higher than 4%), remains as the elective treatment for tuberculosis in HIV infected patients. Due to the interaction between RIF and some antiretovirals drugs, such as proteasa inhibitors, a change in the usual regimens could be necessary. Combinations without RIF or antiretroviral therapy with drugs not interacting with RIF (nucleosides, ritonavir or nevirapin) have been suggested. The emergence of strains of Mycobacterium tuberculosis resistant to the antituberculosis drugs, the lack of adherence to treatment, and the frequency of adverse events hinders even more the control of the tuberculosis and they demand a narrow follow up of these patients. The treatment of the disseminated infection by MAC has improved in the last years with the generalization of the combinations including macrolides as claritromicin or azitromicin with ETB. The doubt persists about what combination is more effective, although like in other opportunists infections associated with a severe immunodeficiency, using antiretrovirals combinations that enhance the immune system could be a fundamental therapeutic approach.

AIDS-Related Opportunistic Infections↗
PubMed1995

[Anticardiolipin antibodies in parenteral drug addicts: relationship with HIV].

The IgG isotype of anticardiolipin antibodies (aCL) and its possible relationship with the immunodeficiency virus (HIV) were studied in 65 parenteral drug addicts (PDA). Thirty-seven patients were infected in the present study. Nineteen (51%) fulfilled diagnostic criteria of AIDS. Thirty-two of these 37 HIV-positive patients (86%) were IgG-aCL positive. Fourteen (50%) of the 28 HIV-negative patients were IgG-aCL positive. Our study reveals a lack of correlation between aCL and thrombocytopenia. None of the patients had thromboembolic complications. In AIDS patients no relationship was found between IgG-aCL levels and the presence of Pneumocystis carinii, other infections by opportunist microorganism, and clinical deterioration. Highly increased levels of IgG-aCL (> 80 GPL) were observed in three patients with AIDS and infectious endocarditis. In conclusion, given the non-specificity of aCL en PDA, it is our opinion that its measurement is of little help in daily clinical praxis.

Adolescent↗
PubMed1993

Successful treatment of antimony-resistant visceral leishmaniasis with liposomal amphotericin B in patients infected with human immunodeficiency virus.

We describe two cases of visceral leishmaniasis in patients infected with human immunodeficiency virus (HIV); both cases were resistant to antimony compounds but were cured with liposomal amphotericin B, with no significant toxicity. A review of the previous reported cases of antimony-resistant visceral leishmaniasis in HIV-infected patients confirmed the effectiveness of treatment with liposomal amphotericin B, which directly targets infected macrophages and reaches high levels in plasma and tissue.

AIDS-Related Opportunistic Infections↗
PubMed1992

[Tuberculosis in 7 general hospitals in Andalusia. Grupo Andaluz para el Estudio de las Enfermedades Infecciosas].

BACKGROUND: To know the clinical features of tuberculosis in our environment, to evaluate its diagnostic techniques and therapeutic options as well as the evolution of patients. PATIENTS AND METHODS: Multicenter retrospective study of 1115 patients with tuberculosis, diagnosed between 1984 and 1988 in the population based areas of 7 Hospitals from Andalusia (Spain). RESULTS: The mean age was less than 40 ages, the exponential growing of the number of cases a year in which the influence of drug addicts could be an important factor, an elevated proportion (45%) of extrapulmonary tuberculosis and disseminated forms, and a social environment of 20% of cases being alcoholics or drug addicts. A good use of diagnostic techniques is recorded, although the use of culture as diagnostic tools is lacking. The usual treatment was three drugs for nine months. The global evolution seems good. However a global mortality of 6.4% is recorded, mainly in disseminated forms and among patients with risk factors for developing tuberculosis. SUMMARY: We have seen an increment among tuberculosis cases, as well as a change in the clinical spectrum of the disease, linked to social illness and drug addiction. The diagnostic approach to tuberculosis seems to be appropriate. The follow up of patients is somewhat confusing.

Adolescent↗