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Miguel Górgolas

Publications and source records attributed to Miguel Górgolas.

5 recordsLinked to original sources

Use of rituximab as a salvage therapy for HIV-associated multicentric Castleman disease.

Several approved therapies for multicentric Castleman disease (MCD) cannot be uniformly applied due to intolerable side effects. There is also a high percentage of recurrence of this disease despite treatment. Rituximab may be effective in controlling MCD in a subset of patients. This paper includes a brief case report and an extensive review of previously published cases. We observed an aggravation of concomitant cutaneous Kaposi sarcoma, and hypothesize that rituximab could have exacerbated it.

Antibodies, Monoclonal↗

Sternal tuberculosis after open heart surgery.

We present a 68-y-old female who had undergone aortocoronary bypass and developed Staphylococcus aureus sternal osteomyelitis. Despite prolonged therapy with different antibiotics and several local debridements and drainage, the wound remained open and suppurative. Only after sternectomy and wide excision of infected costal cartilage was the diagnosis of sternal tuberculosis made, 24 months later. This case illustrates the necessity of a high degree of suspicion to diagnose this very rare entity which coexists with more common causes of sternal osteomyelitis.

Aged↗

[Validation of a questionnaire to estimate satisfaction with antiretroviral treatment: CESTA questionnaire].

BACKGROUND: Assessment of patient satisfaction with antiretroviral therapy is generating increasing interest in clinical practice, since the outcome is directly related with compliance with therapy and its effectiveness. Currently, there is no validated patient satisfaction questionnaire to evaluate this factor as related to control of the disease. PATIENTS AND METHODS: An "ad hoc" questionnaire--Cuestionario Español de Satisfacción con el Tratamiento Antiretroviral (CESTA), Spanish Antiretroviral Treatment Satisfaction Questionnaire--was developed to evaluate satisfaction in patients switching to a simplified regimen. In a second phase, the questionnaire was validated in an observational study including 321 patients divided into two cohorts (patients switching to a simplified regimen and patients maintaining the same regimen). RESULTS: A total of 99% and 93% patients, respectively, completed the questionnaire at baseline and at the end-of-study visit. Cronbach's alpha coefficient for internal consistency and test-retest reliability were 0.82 and 0.69, respectively. Patients switching to a simplified regimen showed a statistically significant higher overall satisfaction score at the third-month visit than at baseline. CONCLUSIONS: The CESTA questionnaire is a valid instrument for use in clinical practice and provides valuable information on patient satisfaction with antiretroviral therapy.

Adult↗

Amphotericin B lipid complex versus no treatment in the secondary prophylaxis of visceral leishmaniasis in HIV-infected patients.

OBJECTIVES: Visceral leishmaniasis (VL) in HIV-positive patients is characterized by a chronic course with frequent relapse. The aim of this study was to evaluate the efficacy and safety of amphotericin B lipid complex (ABLC) in preventing VL relapses in HIV-infected patients. METHODS: This was a multicentre, open-label (with blinded centralized randomization), parallel, no-treatment, controlled clinical trial. HIV-infected patients, with at least one previous treated episode of VL and with negative bone marrow aspirate for Leishmania parasites prior to the study, were randomized to receive either ABLC 3 mg/kg/day every 21 days (ABLC) or no treatment (NT). Patients were followed-up every 9 weeks for up to 12 months, and the efficacy was measured as the proportion of patients remaining free (non-relapse) of VL at 1 year of follow-up. The primary analysis was performed on an intention-to-treat basis. RESULTS: One hundred and fifteen patients were screened, but only 17 were randomized: eight in the ABLC group and nine in the NT group. The intention-to-treat analysis of data showed 50% of patients remaining free of VL at 12 months of follow-up (95% CI = 15.7%, 84.3%) in the ABLC group, and 22.2% (95% CI = 2.8%, 60.0%) in the NT group. The non-relapse odds ratio was 3.5 (95% CI = 0.30%, 52.0%) favouring ABLC. ABLC was well tolerated: patients only presented infusion-related mild adverse events. No patients from either group discontinued treatment or died during follow-up. CONCLUSIONS: ABLC, administered every 21 days for 12 months, is useful as secondary prophylaxis in preventing VL relapse in HIV-infected patients, and is well tolerated.

Adult↗