Specificity of a commercial indirect immunofluorescence technique in the diagnosis of visceral leishmaniasis in patients infected with HIV-1.
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Biomedical subjects
Publications and source records attributed to J Macías.
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PURPOSE: The objectives of this study were to determine the prevalence of osteopenia and the factors associated with its presence in HIV-infected patients under highly active antiretroviral therapy (HAART) and to assess the changes of bone mineral density (BMD) in a population followed prospectively. METHOD: BMD was assessed by dual-energy X-ray absorptiometry (DEXA) scans at the lumbar spine and at the femoral neck in 78 HIV-infected patients who had previously received HAART as the first antiretroviral regimen and in 11 antiretroviral-naive HIV-infected patients. BMD measurements were repeated in 70 treated patients who had completed 1 year of follow-up. RESULTS: Thirty-seven (42%) patients showed osteopenia at any localization. The prevalence of osteopenia in PI-naive patients was 23% versus 49% in individuals who had received PI at any moment [p =.001; adjusted odds ratio (95% CI) = 0.11 (0.02-0.48)]. The frequency of osteopenia was significantly higher among men than among women [50% vs. 17%; p =.016; adjusted OR (95% CI) = 12.1 (2.22-66.20)]. The level of plasma albumin was independently associated with osteopenia [adjusted OR (95% CI) per each g/dL of plasma albumin decrease 2.55 (1.18-10)]. In patients in whom a second DEXA was done, no significant changes in BMD were found. CONCLUSION: The prevalence of osteopenia in HIV-infected patients on HAART is high. Loss of BMD is associated with PI therapy, low plasma albumin level, and male sex. Osteopenia does not progress after 1 year of continued HAART.
Forty patients with uncomplicated urinary tract infections were randomized to receive norfloxacin (400 mg) twice daily or trimethoprim-sulfamethoxazole (160-800 mg) twice daily for 10 days. The percentage of patients with bacteriological outcomes of eradication was significantly greater (p = 0.0310) with norfloxacin (90%) than the obtained percentage with trimethoprim-sulfamethoxazole (55%). The clinical response was, also, significantly better (p = 0.0012) in the norfloxacin group (100%) than in the trimethoprim-sulfamethoxazole group (55%). Two patients receiving trimethoprim-sulfamethoxazole experienced clinical side effects-gastrointestinal in nature but the treatment was not discontinued. In the norfloxacin group clinical side effects were not observed. No adverse hematological or biochemical changes were noted. From these results, we conclude that norfloxacin is more effective than trimethoprim-sulfamethoxazole in the therapy of uncomplicated urinary tract infections.
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