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Biomedical subjects

A Vergara

Publications and source records attributed to A Vergara.

At least 37 records · Page 2Linked to original sources

Prospective evaluation of fever of unknown origin in patients infected with the human immunodeficiency virus. Grupo Andaluz para el Estudio de las Enfermedades Infecciosas.

The aim of this study was to determine the frequency and aetiology of fever of unknown origin (FUO) in patients infected with the human immunodeficiency virus (HIV), to assess the value of the tests used in its diagnosis, and to evaluate possible models of diagnosis for the causes found most frequently. One hundred twenty-eight (3.5%) of 3603 hospitalised HIV-positive patients evaluated from October 1992 to December 1993 had FUO, defined by established criteria. Eighty-six percent of patients with FUO had previously progressed to AIDS. The median CD4+ cell count was 46/mm3. A definite diagnosis was made in 96 (75%) of the 128 patients and a possible diagnosis in 24 (18.7%). whilst no diagnosis was made in eight cases (6.2%). Tuberculosis (48.3%), visceral leishmaniasis (16%), and infection by Mycobacterium avium complex (6.9%) were the diseases found most frequently. The most useful diagnostic tests were liver biopsy (68.9%) and bone marrow aspirate/biopsy (39.7%). It is not possible to predict clinically the cases of FUO due to tuberculosis, whilst thrombocytopaenia < 100,000 cells/mm3 alone is useful for differentiating the cases of visceral leishmaniasis, with a negative predictive value of 95.2%.

Adolescent↗

Socioeconomic differences in cervical cancer: two case-control studies in Colombia and Spain.

OBJECTIVES: This study examined the causes of socioeconomic differences in invasive cervical cancer in two countries that differ substantially in cervical cancer incidence and economic development. METHODS: Data were derived from two case-control studies carried out in Spain and Colombia; there were 373 case subjects, 387 control subjects, and 425 husbands interviewed with a structured questionnaire. Exfoliated cells were obtained from cervical or penile scrapes and tested for human papillomavirus (HPV) DNA. RESULTS: Relative to better educated women, women with low educational levels in both countries reported fewer Pap smears and had a higher prevalence of HPV DNA. The prevalence ratio of HPV DNA across educational strata was twofold in Spain and fourfold in Colombia. In both countries, husbands of poorly educated women reported higher use of prostitutes than husbands of better educated women. In Colombia, 30% of husbands of poorly educated women harbored HPV DNA, compared with 10% of husbands of better educated women. CONCLUSIONS: Socioeconomic differences in invasive cervical cancer could be partly explained by differences in the prevalence of HPV DNA and by a lower use of preventive care.

Adult↗

Association between hepatitis C virus seroreactivity and HIV infection in non-intravenous drug abusing prostitutes.

Two hundred and ninety-four non-transfused prostitutes from Spain, who denied intravenous drug abuse, were tested for hepatitis C virus (HCV) antibodies. Seventeen (5.78%) of them were seropositive. Both in univariate and correspondence analyses, serological results for hepatitis C were associated with the HIV-1 serostatus (p < 0.001), number of sex partners (p < 0.05) and a history of genital ulcers (p < 0.05). In logistic regression analysis, hepatitis C seropositivity was associated only with HIV-1 infection (adjusted odds ratio = 13.6; 95% confidence interval = 3.3-55.2). These results show that hepatitis C seropositivity is associated with HIV-1 infection in female non-intravenous drug abusing prostitutes. These findings are also consistent with the hypothesis that HCV can be sexually transmitted with low efficiency.

Adult↗

Human T-lymphotropic virus type I (HTLV-I)-specific antibodies and cell-free RNA in crevicular fluid-rich saliva from patients with tropical spastic paraparesis/HTLV-I-associated myelopathy.

Despite the likely role of mucosae in human T cell leukemia virus type I (HTLV-I) transmission, little is known about the mucosal immune response to HTLV-I. The present study evaluated the antibody response to HTLV-I in oral mucosa and the value of crevicular fluid rich saliva (CFRS) for diagnosing HTLV-I infection. CFRS and sera from patients with tropical spastic paraparesis/HTLV-I-associated myelopathy (TSP/HAM), asymptomatic carriers, and HTLV-I seronegative individuals from Tumaco, Colombia, were analyzed for HTLV-I specific IgG, IgA, and secretory IgA (sIgA). Detection of IgG in CFRS by enzyme-linked immunosorbent assay correlated with its presence in sera for TSP/HAM patients and asymptomatic carriers. IgA and sIgA were more frequently detected in CFRS and sera from TSP/HAM patients than in those from asymptomatic carriers. An HTLV-I pol fragment could be amplified from CFRS by reverse transcriptase-PCR in 3 TSP/HAM patients and one asymptomatic carrier, all of whom had an IgA response in CFRS but not in sera. The more frequent detection of IgA and sIgA in sera and CFRS of TSP/HAM patients suggests increased viral replication. Further, the association of viral RNA in CFRS with a local IgA response may signify rounds of viral replication in the oral cavity.

Antibody Specificity↗

Prospective evaluation of a two-week course of intravenous antibiotics in intravenous drug addicts with infective endocarditis. Grupo de Estudio de Enfermedades Infecciosas de la Provincia de Cádiz.

In a prospective study, a two-week course of antibiotics (cloxacillin 2 g/4 h plus amikacin 7.5 mg/kg/12 h) was evaluated in the therapy of right-sided infective endocarditis in intravenous drug users (IVDU). All IVDU admitted to hospital during the study period who fulfilled the strict criteria for diagnosis of infective endocarditis were analysed. A subgroup of patients with right-sided endocarditis caused by Staphylococcus aureus who had a good prognosis were selected as being eligible for the two-week course of treatment. In a total of 139 episodes of infective endocarditis in IVDU, 72 (51.8%) cases were eligible for the two-week treatment. Of this group, 67 were cured, 4 needed prolongation of treatment to cure the infection and 1 died in hospital of respiratory distress syndrome on day 10 of treatment. In patients not eligible for the two-week treatment, the mortality was higher (24.2% versus 0.7%; p = 0.00015). Drug toxicity in the treated group was low. It can be concluded that administration of cloxacillin and amikacin parenterally for 14 consecutive days was successful in the therapy of right-sided endocarditis in IVDU.

Adult↗

Improved detection of HIV p24 antigen in serum after acid pretreatment.

HIV-1 p24 antigen was detected in 554 sera (509 from HIV-1 seropositive individuals and 45 sera from seronegative controls) using a conventional method with acid pretreatment of the sample in order to separate the p24 antigen/anti-p24 antibody immune complexes. In asymptomatic individuals there was a substantial increase in antigen detection (48.2% vs 8.4%). Similar results were also observed in ARC (59.1% vs 12.2%) and AIDS patients (85.7% vs 37.1%). It can be concluded that the acid treatment improves the sensitivity of conventional techniques to detect HIV-1 p24 antigen.

Female↗

Toxicity assessment of atrazine, alachlor, and carbofuran and their respective environmental metabolites using Microtox.

Using the Microtox method of toxicity assessment designed by Microbics Corporation, the relative toxicities of alachlor, atrazine, and carbofuran, three pesticides commonly used in agricultural production, were determined. Generally, carbofuran was found to be most acutely toxic, followed closely by atrazine. Alachlor was least toxic of the three pesticides tested. Selected environmental metabolites of these three agri-chemicals were also tested using the same method. Hydroxyalachlor, deethylatrazine, deisopropylatrazine, 3-hydroxycarbofuran, and 3-ketocarbofuran were selected for analysis because previous studies determined their presence in surface and ground-water supplies along with their parents. Results showed that often the metabolites were at least as acutely toxic as their parents, particularly in the case of 3-ketocarbofuran and hydroxyalachlor, which demonstrated toxicities higher or not significantly different than their parents. Hydroxycarbofuran was assessed as the least toxic of all substances tested. The atrazine environmental metabolites were less toxic than their parent.

Acetamides↗

HIV-1 infection among non-intravenous drug user female prostitutes in Spain. No evidence of evolution to pattern II.

OBJECTIVES: To assess the prevalence of HIV-1 infection among non-intravenous drug user (IVDU) female prostitutes in Spain and to determine risk factors for HIV-1 infection in this population. DESIGN: Cross-sectional seroepidemiological study of 519 non-IVDU prostitutes. SETTING: Four university hospitals. METHODS: All participants completed a questionnaire and provided a serum sample. Serum samples were tested for antibodies against HIV-1, hepatitis C virus (HCV) and Treponema pallidum. RESULTS: Twelve out of the 519 (2.31%) participants were HIV-1-seropositive. HIV-1 infection was associated with the presence of both HCV and T. pallidum antibodies, multiple sex partners, longer history of prostitution, history of genital ulcers and anal intercourse. Condom use was associated with HIV-1 seronegativity. CONCLUSIONS: The prevalence of HIV-1 infection in non-IVDU prostitutes in Spain remains relatively low. Risk increases with a higher rate of sexual exposure and practices such as anal intercourse and unprotected coitus.

Adolescent↗

[Time trends in cancer incidence in Navarra and Zaragoza, spain].

BACKGROUND AND OBJECTIVES: The knowledge of time-related changes occurring in cancer incidence and mortality is an essential element for cancer control. This paper aims to describe the time trends of the more important cancer sites in Navarra and Zaragoza. METHODS: The influence of age, diagnosis period and birth cohort on the observed time trend cancer incidence in Navarre and Zaragoza was assessed using a log-linear model. Results are showed graphically, for the different tumour sites by sex and each registry. RESULTS: Among males, a considerable rise in the incidence of lung cancer (5% per year), prostate cancer (> 2% per year) and non-Hodgkin's lymphomas was found. Among females, the highest increases corresponded to non-Hodgkin's lymphomas, with a yearly rise greater than 7%, and ovarian cancer (4% per year). Breast cancer in women increased in both registries (3.5% per year in Navarre and 0.9% per year in Zaragoza), part of the increment in Navarra being explained by a higher case detection rate. Finally, the incidence of colorectal, bladder and kidney cancer rose more than a 3% per year in both registries and sexes. For most types of tumours, cancer risk increased with subsequent generations. CONCLUSION: The substantial cancer increment observed points out the inefficacy of primary prevention policies, the importance of studying cancer incidence for long time periods and the need to increase the population coverage of Spanish cancer registries.

Adult↗