The use of intravenous amiodarone was assessed during 23 episodes of paroxysmal supraventricular tachycardia in 15 children aged 9 days to 11 years. Five of the fifteen patients had congenital structural heart disease, and three had Wolf-Parkinson-White syndrome. Tachyarrhythmias were returned to sinus rhythm during 20 of the 23 episodes (87%). No major adverse effects occurred. Recurrence of tachycardia was not observed during short-term follow-up. In conclusion, intravenous amiodarone is an effective, safe antiarrhythmic drug for short-term treatment of supraventricular tachycardia in children.

Amiodarone↗

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[PET detection of a primary gall bladder tumor and pericystic metastatic adenopathy].

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Adenocarcinoma↗

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Immunological regulation of intestinal epithelial transport.

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Animals↗

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Simplicity and efficacy of a once-daily antiretroviral regimen with didanosine, lamivudine, and efavirenz in naïve patients: the VESD study.

PURPOSE: Our aim was to analyze the efficacy and safety of didanosine-lamivudine-efavirenz in a cohort of HIV patients starting antiretroviral therapy between January and September 2003. METHOD: We undertook a prospective, open-label, observational, multicenter study. RESULTS: 163 patients were enrolled. Over a 48-week period, plasma HIV RNA levels declined sharply, with a median decrease at the end of the observation time of >4.62 log copies/mL. The proportion of patients achieving a plasma HIV RNA level below 50 copies/mL was 62.9% (intention-to-treat analysis) at the end of the study period. The mean CD4 cell count increased steadily over time by 199 cells/microL. Antiviral efficacy was similar in patients with a baseline HIV RNA level above or below 100,000 copies/mL. Overall, 57 (34.1%) patients interrupted therapy; 9 due to lack of treatment response, 18 due to adverse side-effects, and 30 patients lost to follow-up or who withdrew their consent. Adherence was very high (90%-95%) and quality of life was good or very good in 69%. CONCLUSION: The once-daily combination of didanosine-lamivudine-efavirenz resulted in sustained viral suppression and was well-accepted by patients under real-life conditions, even immunosuppressed patients and those with a high viral load. Associated adverse events and virological failures were few.

Administration, Oral↗

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Response to liposomal doxorubicin and clinical outcome of HIV-1-infected patients with Kaposi's sarcoma receiving highly active antiretroviral therapy.

PURPOSE: HIV-associated Kaposi's sarcoma (KS) may not resolve despite highly active antiretroviral therapy (HAART). Moreover, the therapeutic goal has shifted from palliative care to long-term durable complete remission. The objective of the study was to assess the impact of liposomal doxorubicin in the treatment of HIV-associated KS in the HAART era. METHOD: In this prospective, noncomparative, multicenter study, patients with more than 10 cutaneous lesions or visceral disease were treated with 20 mg/m(2) of liposomal doxorubicin (Caelyx) every 3 weeks in addition to their antiretroviral therapy. In addition to tumor measurements and laboratory tests, human herpes virus 8 (HHV-8) polymerase chain reaction (PCR) in peripheral blood mononuclear cells (PBMC) was performed. RESULTS: Out of 79 participants enrolled in the study, 47 (59%) had stage T(1), 41 (52%) I(1), and 32 (40%) S(1). Nine individuals were not evaluable for response, 32 (40%) had complete response, 30 (38%) partial response, 5 (6%) stable disease, and 3 (4%) progression. Regression analysis did not find any statistically significant factor predicting response. HHV-8 PCR was positive in 37/53 (70%) patients with available PBMC samples, and HHV-8 viremia cleared in 14/27 (52%) without correlation with clinical response. Eleven (14%) participants experienced a relapse of KS, while at the last update of data, 49 (62%) remained stable. The only risk factor for recurrence identified was the follow-up time (odds ratio [OR] 1.21, 95% CI 1.07-1.36; p =.002). CONCLUSION: The response rate of AIDS-associated KS to liposomal doxorubicin administered with HAART was high, and most often the response was durable. HHV-8 viremia did not correlate well with clinical outcome.

AIDS-Related Opportunistic Infections↗

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[Cervico-dorsal intramedullary lipoma of neonatal presentation].

INTRODUCTION AND CLINICAL CASE: We present the case of a ten day old boy with cervicodorsal intramedullary lipoma. The initial clinical presentation was of rapidly progressing unilateral brachial paralysis. Neurological examination at birth was completely normal apart from a cutaneous port wine stain on the shoulder homolateral to the paralysis thought to be due to an angiolipoma. On clinical suspicion of an intradural space-occupying lesion at cervical level, a magnetic resonance study was done which showed an intramedullary tumour at cervicodorsal level extending from C3 to T3, which disappeared with the fat suppression technique, a finding characteristic of lipomas. The anatomo-pathological report was that the mass was a tumour made up of mature fat cells in a connective tissue stroma, with no malignant formation or granulomatous components. Lipomas are the second most common spinal tumors in infancy after neuroblastoma. This type of tumour is usually found at lumbosacral level and is considered to be congenital. CONCLUSIONS: This lipoma was unusual in being cervicodorsal (a common site in adults but not in infancy), being intramedullary (most are extramedullary even when they are intradural), presentation being so early during the neonatal period, rapidly progressive and relapsing after surgical removal.

Angiolipoma↗

PubMedDate not supplied

Non-traumatic intracerebral hemorrhage in young adults living in Guayaquil, Ecuador (South America): analysis of 151 patients.

We studied 151 patients aged 15 to 44 years with non-traumatic intracerebral hemorrhage admitted to a large public hospital over a 10-year period. Patients were evaluated for an association of death or severe disability after the stroke with the following variables: sex, age, location of the hemorrhage, and possible etiology. Lobar hemorrhages were found in 63 (41.7%) patients, putaminal hemorrhages in 39 (25.8%), posterior fossa hemorrhages in 24 (15.9%), and hemorrhages in other locations in 25 (16.6%). A possible etiology was determined in 109 (72.2%) patients. Hypertensive arteriolopathy accounted for 60 (39.7%) cases, rupture of a saccular aneurysm or a vascular malformation for 33 (21.9%), and other etiologies for 16 (10.6%). Thirty-four (22.5%) patients died after the acute event. The age of the patient, the location, and the etiology of the hemorrhage had no prognostic significance for mortality. In contrast, these factors predicted the degree of functional recovery in survivors. The best prognosis was noted in patients younger than 35 years with lobar hemorrhages of undetermined etiology, and the worst prognosis was noted in patients aged 35-44 years with putaminal or posterior fossa hemorrhages related to hypertensive arteriolopathy.

Activities of Daily Living↗