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S Echevarría

Publications and source records attributed to S Echevarría.

At least 19 recordsLinked to original sources
PubMed2001

Limited immune reconstitution at intermediate stages of HIV-1 infection during one year of highly active antiretroviral therapy in antiretroviral-naive versus non-naive adults.

Although several reports have attributed the clinical benefits of highly active antiretroviral therapy (HAART) to a possible immune restoration, long-term data are still scarce and most derive from patients with either advanced or very early stages of HIV infection. In the present study, changes in lymphocyte subsets, activation markers, and adhesion molecules in CD4+ and CD8+ lymphocytes were carefully monitored over a 1-year period in 27 HIV-infected adults at an intermediate stage of HIV infection. Cytokine-producing patterns were also studied. In these patients the HIV viral load disappeared by month 4 of HAART. Only limited immunological changes were observed: an incomplete recovery of naive CD4+ T cells, a less activated state of CD8+ T cells, and a repopulation of IL-2- and IFN-gamma-producing CD4+ T cells. These changes were observed principally in patients with more advanced disease. Furthermore, HIV-infected subjects who had received HAART previously showed less marked immunological changes than antiretroviral-naive individuals. In conclusion, the sustained viral suppression during 1 year of HAART was accompanied by limited immunological recovery at intermediate stages of HIV infection. This finding indicates a need for longer HIV suppression in order to achieve effective recovery of the immune system.

ADP-ribosyl Cyclase↗
PubMed2000

Cutaneous metastases as initial manifestation of dedifferentiated chondrosarcoma of bone. An autopsy case with review of the literature.

Metastases of chondrosarcoma to the skin are uncommon. We report a case of dedifferentiated chondrosarcoma that manifested as cutaneous metastases and had an outcome of three weeks. A 69-year-old male presented with two cutaneous nodules, one in the chest and other in the inguinal area. The punch biopsy of the latter showed a poorly differentiated mesenchymal metastatic tumor. Shortly before death, an X-ray revealed a proximal epiphyseal lesion in the right humerus, radiographically interpreted as chondrosarcoma. The autopsy showed this lesion to be a dedifferentiated chondrosarcoma whose nonchondroid mesenchymal part was akin, histologically and immunohistochemically, to the cutaneous metastases. While ten previous reports of chondrosarcoma metastatic to the skin are known, we believe that this is the first case to report the cutaneous metastases of the dedifferentiated variety. Furthermore, skin metastasis preceding the diagnosis of chondrosarcoma has not been previously reported. The fact that one part of this kind of tumor can be highly undifferentiated or, else, differentiated along lines not usually reminiscent of bone tumors, can make the diagnosis of such cases extremely difficult. Most chondrosarcomas metastatic to the skin arise in bones of the extremities, including the hand. The most common type of tumor is conventional chondrosarcoma. These metastases can be either single or multiple with a slight predilection for the head and neck region. Most patients die in a mean time of 6 months after the appearance of cutaneous metastases.

Aged↗
PubMed1997

Atypical coccidioidomycosis in an AIDS patient successfully treated with fluconazole.

Cervical lymphadenopathy due to Coccidioides immitis occurred as the sole opportunistic infection in a Spanish patient with the acquired immunodeficiency syndrome. Twelve years earlier the patient had lived in the desert regions of the southwestern USA. After an initial course of high doses of fluconazole, the patient recovered without any sequelae. This is the first case of coccidioidomycosis in Spain.

AIDS-Related Opportunistic Infections↗
PubMed1997

Neuroleptic malignant syndrome in the acquired immunodeficiency syndrome.

Patients infected by the human immunodeficiency virus are predisposed to many infectious and noninfectious complications and often receive a variety of drugs. Furthermore, they seem to have a particular susceptibility to idiosyncratic adverse drug reactions. It is therefore surprising that only a few cases of the neuroleptic malignant syndrome have been described in patients with the acquired immunodeficiency syndrome. A high index of suspicion is required to diagnose the neuroleptic malignant syndrome in these patients, as its usual manifestations, including fever and altered consciousness, are frequently attributed to an underlying infection.

Acquired Immunodeficiency Syndrome↗
PubMed1994

[Human immunodeficiency virus infection in an emergency department].

Unlabeled serum samples from patients attended at the Emergency Department of our Hospital were collected for a 10-week period to measure the presence of anti-HIV antibodies and assess the prevalence of the infection in this population. Both suspected (with warning mark on samples) and non-suspected patients of having the infection were included. Concurrently, health care personnel in the Emergency Department were asked to complete a questionnaire on issues concerning the knowledge of this infection and the precautions to adopt. The compliance of these measures was verified. Only 3 from the 2,293 samples from nonsuspected patients were positive (0.13%). The 79 samples from suspected patients corresponded to 44 persons with previously known infection and 35 persons engaging in high-risk behaviours; from the latter group 11 were ultimately positive. Although health care personnel was aware of precautions, they only adopted them with suspected patients but incorrectly. Thus, there was inconsistency between the perceived risk by health care personnel and the precautions adopted. While the prevalence of HIV infection is still low in the attended population at the Emergency Department, efforts must be made to decrease accidental exposures, as an increase in its prevalence is to be expected.

Adolescent↗
PubMed1994

[Influence of hepatitis C virus infection and human immunodeficiency on the natural history of chronic delta hepatitis].

OBJECTIVES: To analyze the prevalence and clinical significance of HCV an HIV infections among a group of patients with chronic delta hepatitis. METHODS: We have studied the clinical and the histological activity and the serological profile the HBV DNA was analyzed by dot blot and PCR and the HDV RNA by dot blot) in 46 patients with chronic delta hepatitis. These results were correlated with HCV infection (assessed by ELISA-2, RIBA-2 and RT-PCR) and HIV infection (ELISA and immunoblot). RESULTS: HBV DNA and HDV RNA was detected by dot in 28.2% and 71.4% of patients respectively, and by PCR, 89.1% of patients had HBV DNA in their serum. Twenty two of 46 patients with chronic delta hepatitis were anti-HCV positives (with HCV RNA detectable in sera by RT-PCR in 19 cases). Anti-HIV positivity was detected in 19 of 46 patients. The mean aminotransferase level, histological activity and serological profile was similar in the anti-HCV positive and negative patients. Likewise, clinical and histological activity and serological profile was similar in the anti-HIV positive and negative patients. CONCLUSIONS: Concomitant infection with HCV or HIV does not seem to significantly modify the clinical course of chronic delta hepatitis. In addition, no significant serological difference has been noted in patients with chronic delta hepatitis with anti-HIV or anti-HCV antibodies.

Adult↗
PubMed1993

Renal failure due to sulphadiazine in AIDS patients with cerebral toxoplasmosis.

Cerebral toxoplasmosis is optimally treated with the combination of high doses of sulphadiazine and pyrimethamine. We described two patients with AIDS treated for cerebral toxoplasmosis who developed renal failure due to sulphadiazine-induced crystalluria. Symptoms and renal failure were rapidly reversed with urine alkalinization and hydration. A careful monitoring and adequate hydration of patients with AIDS treated with high doses of sulphadiazine appears mandatory to avoid this complication.

AIDS-Related Opportunistic Infections↗
PubMed1993

[An analysis of 100 consecutive tuberculosis cases in HIV-infected patients in a hospital in Cantabria].

UNLABELLED: In our setting, patients infected by human immunodeficiency virus (HIV) show a high rate of tuberculosis infections which manifestations depend on the level of immunodeficiency reached. METHOD: Clinical, radiological and evolutive characteristics are discussed of 100 diagnosed tuberculosis in seropositive patients during a time span of 52 months, relating them to the number of CD4 detected. RESULTS: Tuberculosis pulmonary forms (65%) were more frequent than extra-pulmonary ones (35%) even in the advanced phases of the disease due to HIV, even tough the latter tend to cluster in patients with less than 200 CD1/mm. An unspecific febrile syndrome, normal results on simple radiological exploration and the difficulty to obtain diagnostic samples are facts which often delay the diagnosis. CONCLUSION: Even tough the extra-pulmonary forms are more frequent in the last stages of the disease due to HIV, in our setting there is still a high incidence of pulmonary forms in all stages.

AIDS-Related Opportunistic Infections↗
PubMed1989

Aortobronchial fistula: an uncommon cause of haemoptysis.

A 16 year old patient who presented with haemoptysis as the main manifestation of the infection of an aortic patch graft is reported. The importance of being alert about the possibility of an aortobronchial fistula in patients with haemoptysis who have been previously subjected to cardiovascular surgery is emphasized.

Adolescent↗
PubMed1989

[Tumoral hypocalcemia].

Hypocalcemia is a rare and not well understood paraneoplasic manifestation. We report the clinical case of a patient with hypocalcemia due to extensive osteoblastic metastasis. The corrected serum calcium levels for albumin was 7.2 mg/dl. Calciuria was less than 10 mg/24 h. Magnesium, phosphate and 25-hydroxyvitamin D levels were normal. PTH and 1,25-dihydroxyvitamin D levels were increased. The pathogenesis of this disorder is possibly related to the massive calcium flow toward metastatic areas, that can not be compensated for by the activity of the PTH-vitamin D axis.

Aged↗