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Biomedical subjects

R Quilichini

Publications and source records attributed to R Quilichini.

At least 37 records · Page 2Linked to original sources
PubMed1992

[HIV cofactors in the course of AIDS].

The responsibility of HIV in the occurrence of AIDS is definitely established, but "cofactors" are strongly suspected to intervene, which would explain the difference courses followed by the disease in one patient or the other. Some of these cofactors are related to the host or result from his behaviour. Thus, age at the time of HIV acquisition and the patient's HLA group are associated with differences in the speed of progression towards AIDS. Attitudes that lead to reexposure to the virus by the sexual or intravenous routes shorten the duration of the asymptomatic phase. Other cofactors are environmental in nature. Among the infectious agents, cytomegalovirus and some mycoplasmas have been the object of the most through studies. The responsibility of some physicochemical substances, such as cocaine, vitamin D and corticosteroids, acting as cofactors of increasing severity, mostly rests on data obtained in vitro and need clinical confirmation in man. However, the study of cofactors already seems to be a promising line of research aimed at understanding AIDS and hence its therapeutic approach.

AIDS-Related Opportunistic Infections↗
PubMed1992

Endothelial cell dysfunction in HIV infection.

We have investigated plasma levels of endothelial cell products playing a role in hemostasis in 125 HIV-positive patients and 30 controls. Antigenic von Willebrand factor increased significantly with disease progression and was closely correlated with CD4+ cell counts and beta 2-microglobulin levels. Tissue-type plasminogen activator was normal in CDC II/III and CDC IVC2 patients and was slightly increased in AIDS patients, whereas plasminogen activator inhibitor was increased in each group, the stage of the disease not having any effect. Mean total protein S levels were lower in HIV-positive patients and, in 27.2% of the cases, were associated with a decrease in free protein S levels. Such abnormalities could be responsible for a hypercoagulable state in these patients and could be explained by endothelial cell damage during HIV infection. Whether this injury is due to HIV itself remains to be further investigated.

Adult↗
PubMed1992

[Disseminated lupus erythematosus discovered during delivery: a difficult diagnosis].

The authors report a case of lupus showed in labour by the presence of generalised convulsions and coma after the crisis. This was followed by labile transitory hypertension, by massive proteinuria which cleared in 15 days, by major hyperthermia (higher than 39.5 degrees) and transitory agranulocytosis. The infant had a purely biological neonatal lupus. Pregnancy in a lupus patient has two risks: the mother's relapses of lupus, it is usual that renal failure is the worst of the prognostic features, but in this patient cerebral complications were much more serious. In the fetus there is a risk of spontaneous abortion linked to the anticardiolipin antibody level, and the risk of disease in the heart due to the anti-SSA (or anti-Ro) factor giving rise to congenital auriculo-ventricular blocks. The therapeutic possibilities are classically treated with immunosuppressants, mainly corticoids, which is added to low doses of aspirin. Plasmaphoresis and immunoglobulin treatments are being tried out.

Adolescent↗
PubMed1991

[Epilepsy seizures in HIV infection. 52 cases].

Fifty-two patients at various stages of human immunodeficiency virus (HIV) infection who had one or several epileptic seizures in the course of that disease were retrospectively studied from 1985 to 1990. Thirty-five percent of these patients were in overt clinical AIDS at the time of the seizure(s). AIDS was revealed by a seizure in 2 cases. Generalized seizures were observed in 71 percent of the patients, and partial seizures in 29 percent. Electroencephalograms showed signs of brain irritation in only 19 percent of the cases. The cause of epileptic seizure(s) could be determined in 36 patients: cerebral toxoplasmosis in 23 cases; progressive multifocal leucoencephalitis in 2 cases; HIV encephalopathy in 3 cases; iatrogenic cause in 4 cases; meningoencephalitis in 3 cases and neurosyphilis in 1 case. No cause other than HIV infection was found in 16 patients. These findings confirm those of previous studies. In about one-third of AIDS patients epileptic seizures are the only clinical manifestation of viral central nervous system infection.

AIDS Dementia Complex↗
PubMed1991

[Kaposi's sarcoma in AIDS. 70 cases].

Although Kaposi's sarcoma is the most frequent of malignant diseases associated with AIDS and one of the first recognized manifestations of the syndrome, its management has not yet been standardized. This study concerns 70 AIDS patients with Kaposi's sarcoma followed up in the author's hospital department between june 1985 and december 1989. Most of these patients were homosexual or bisexual males. The mean time elapsed between the finding of a positive HIV test and the discovery of Kaposi's sarcoma was 15 +/- 3.2 months. Systematic evaluation disclosed visceral lesions in 50 percent of the patients. Chemotherapy was used in 55 cases, interferon-alpha in 23 cases and radiotherapy in 13 cases. The presence of visceral lesions clearly reduced survival time, although deaths were mainly due to opportunistic infections. Atypical forms of Kaposi's sarcoma sometimes make its diagnosis difficult, but the main problem is that of treatment, in view of the underlying immunodepression. The authors advocate the setting up of multicentre trials aimed at determining the best therapeutic approach in these patients.

Acquired Immunodeficiency Syndrome↗