Oral clinical markers and viral load in a prospective cohort of Mexican HIV-infected patients.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to S Ponce-de-Leon.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A double-blind, randomized, placebo-controlled clinical trial was performed in Mexico City to evaluate the efficacy of thalidomide in treating oral recurrent aphthae in human immunodeficiency virus (HIV)-infected subjects. Sixteen HIV-infected patients with clinical and histological diagnosis of oral recurrent aphthous ulcerations received randomly an 8-week course of either thalidomide or placebo, with an initial oral dosage of 400 mg/d for 1 week, followed by 200 mg/d for 7 weeks. Ten subjects received thalidomide and six received placebo. At 8 weeks, nine subjects (90%) in the thalidomide group had complete healing of their ulcers, compared with two (33.3%) of the six patients in the placebo group (P = .03). There was a significant reduction in largest ulcer diameter in the thalidomide group. Rash was observed in 80% of the thalidomide patients. Although thalidomide demonstrated an unquestionable benefit in treatment of oral ulcers in HIV patients, caution must be taken given the frequent occurrence of side effects.
A cross-sectional analysis was conducted in Mexico City from September 1989 to March 1996, to determine the prevalence of HIV-related oral manifestations by gender and route of HIV transmission. The diagnosis of HIV-associated oral lesions was based on preestablished criteria. For the statistical analysis chi-squared and Fisher's exact tests were used where appropriate. Odds ratios were calculated as estimates of the relative risks. Control of confounding factors was performed by logistic regression models. Oral lesions were present in 75% of 436 HIV+ patients. Hairy leukoplakia, erythematous and pseudomembranous candidosis, angular cheilitis and oral ulcers were frequently found. Patients who contracted HIV through blood transfusion were more likely to present erythematous candidosis (P=0.005) than subjects who acquired HIV through sexual transmission. Oral ulcers were seen only in men (P=0.02) and in individuals who contracted HIV through sexual transmission (P=0.02). This study brings valuable data in regard to differences in the type and prevalence of HIV-related oral lesions by gender and the risk categories analysed, particularly blood transfusion.
The surgical morbidity rate of patients with Systemic Lupus Erythematosus is considered very high; however, the experience in the literature is small. This study will determine the rate of surgical morbidity and the existence of predictive factors in patients with such a disease. The medical records of 53 patients with Systemic Lupus Erythematosus who underwent 63 major operations were analyzed retrospectively. The rate and causes of operative morbidity were registered. Univariate and multivariate statistical analysis was performed to ascertain the existence of predictive factors for morbidity. The overall morbidity and mortality were 16% and 6% respectively. Lymphopenia, hypoalbuminemia, increased SGOT and SGPT, urgent indication of operation, the physical status of the American Society of Anesthesiology, as well as a shorter duration of Systemic Lupus Erythematosus showed a significant correlation with operative morbidity in the univariate analysis; high blood urea nitrogen showed marginal significance. Physical status, urgent indication, and blood urea nitrogen remained as significant variables with the multivariate logistic regression analysis. The surgical morbidity rate of these patients may be lower than previously estimated. The physical status, urgency of operation, and level of blood urea nitrogen seemed to be the most useful independent predictors for surgical morbidity risk in patients with Systemic Lupus Erythematosus.
Nosocomial infections in developing countries represent a major public health problem that is not universally recognized. In Latin America rates for nosocomial infections range from 10 to 26% with a severe impact on morbidity and mortality and a consequent economic burden. The fundamental needs are: (1) to recognize the importance of this problem; (2) to modify the attitude of government authorities in the sense that hospital care could be improved; (3) to teach medical personnel the importance of infection control at the beginning of their training; and (4) to increase the awareness of the population of its right to better health care. From an international point of view we should establish the following guidelines: (1) the World Health Organisation should establish a worldwide programme on nosocomial infections; (2) medical and nursing schools should include regular courses on infection control; (3) international organizations should support training and research programmes in developing countries, focusing on the regional needs for infection control.
Antigenaemia due to human immunodeficiency virus (HIV) is thought to be significant either before the appearance of a specific antibody response, or after its decline during terminal stages. In order to increase the rate of detection of HIV antigen carriers, regardless of the stage or despite the presence of specific serum antibodies, we assayed, simultaneously, plasma samples and extracts from resting and phytohaemagglutinin-stimulated mononuclear cells from 25 infected, anti-body-positive individuals and 10 healthy, antibody-negative female volunteer blood donors. We detected the presence of HIV antigen in at least one of the three types of specimens obtained from all the 25 infected subjects but in none of the 10 healthy blood donors. This approach might prove most useful for the study of patients with controversial or equivocal antibody test results.