[CD4+ lymphocytes and opportunistic infections and neoplasms in patients with human immunodeficiency virus infection].

Background: The CD4+ lymphocytes are the principal target cell for the human immunodeficiency virus (HIV). Their depletion originates a very severe cell immunosuppression, which conditions the appearance of opportunistic infections and neoplasms characteristic of AIDS. The aim of this study was to evaluate whether there is a relation between the degree of cell immunosuppression and the type of opportunistic infections and neoplasms which these patients develop in Spain.

[Therapeutic alternatives for cases of cerebral toxoplasmosis in patients with AIDS: clarithromycin and atovaquone].

Background: Cerebral toxoplasmosis is the most common opportunistic infection of the central nervous system in AIDS patients. Its rate varies between 3-40% according to the prevalence of toxoplasmosis in the different geographic areas. Conventional treatments used for this pathology are: sulphadiacin or clindamycin plus pyrimethamine, but all can occasionally produce severe side effects.

[Incidence of enteropathogens in patients with human immunodeficiency virus infection].

Background: To establish the incidence of diarrhea and its evolution over time, the causal microorganisms, recurrence and associated mortality in patients with AIDS or severe immunologic alterations (CD4 lymphocytes lower than 0.5 x 10(9)/l).

Methods: A prospective longitudinal study was carried out from 1984 to 1992.

[Varicella pneumonia in adults infected by HIV-1. Presentation of 2 cases].

Background: Infection by the varicella-zoster virus (VZV) is frequent in patients infected by the HIV-1. Nonetheless, visceral involvement in addition to that of pneumonia is rare, despite the important immune dysfunction found among these patients.

Methods: Varicella pneumonia was diagnosed in 2 patients with HIV-1 infection who presented cough with high fever and a characteristic rash in addition to respiratory failure and a micronodular pattern on chest radiography.

A prospective study of the risk of tuberculosis among HIV-infected patients.

Objective: To evaluate the risk of developing active tuberculosis (TB) in a cohort of HIV-1-infected patients.

Methods: Prospective longitudinal follow-up of 839 HIV-infected patients, of whom 505 (60%) were parenteral drug users and 269 (32%) homosexual men. Tuberculin skin tests were performed at baseline and annually thereafter.

[Subcutaneous venous reservoirs: comparative study of their efficacy in patients with AIDS versus oncology and hematology patients].

Background: Chronic venous access may constitute a serious problem in some patients and the subcutaneous venous reservoirs have demonstrated to be a useful alternative. AIDS patients require intense pharmacologic treatment, thus the use of subcutaneous venous reservoirs may be specially useful. However, the prevalence of septic type complications following placement of the subcutaneous venous reservoirs in these patients is particularly high.

[Epidemic Kaposi's sarcoma in women: presentation of 4 cases].

Epidemic Kaposi's sarcoma is the neoplasm most frequently manifested in infection by the human immunodeficiency virus. Its prevalence is considerably higher among homosexual males than among intravenous drug users with practically exclusive infection in this sex. Four cases of Kaposi's sarcoma in women with the human immunodeficiency virus are described.

Primary prophylaxis for Pneumocystis carinii pneumonia: a randomized trial comparing cotrimoxazole, aerosolized pentamidine and dapsone plus pyrimethamine.

Objective: To compare the efficacy and tolerance of monthly aerosolized pentamidine versus cotrimoxazole versus dapsone plus pyrimethamine to prevent the initial episodes of Pneumocystis carinii pneumonia (PCP) in HIV-infected patients.

Design: An open randomized clinical trial.

Patients And Methods: HIV-infected patients (n = 331) with CD4 cell counts < 200 x 10(6)/l or with AIDS but without a history of PCP or cerebral toxoplasmosis (CT) were randomized to receive pentamidine (300 mg every 4 weeks), cotrimoxazole (160/800 mg 3 days a week) or dapsone plus pyrimethamine (100 and 25 mg weekly).

Disseminated candidiasis in addicts who use brown heroin: report of 83 cases and review.

From November 1983 to April 1990, disseminated candidiasis was diagnosed in 83 heroin addicts at our institution. All patients had consumed brown heroin diluted in fresh lemon juice. Sixty-two (75%) had skin lesions, 41 (49%) had ocular lesions, and 35 (42%) had one or several costochondral tumors.

[Cryptococcosis: presentation of 26 cases].

Background: Cryptococcosis is more frequently observed since the appearance of the acquired immunodeficiency syndrome (AIDS). AIDS has modified the clinical and evolutive forms of the disease. This study reviews the changes produced in the infection from the context of AIDS.

[Study of neurological and cognitive changes in patients in stage III and initial phases of stage IV of infection by human immunodeficiency virus type 1].

Background: To evaluate the prevalence of neurological and cognitive disorders in patients with the human immunodeficiency virus type 1 (HIV-1).

Methods: A transversal prospective study was carried out in 56 patients with HIV-1 and in 18 seronegative subjects by a protocolized neurological and cognitive examination.

Results: Twenty-seven patients were intravenous drug users (IVDU) and 29 were male homosexuals.

Influence of treatment with zidovudine (ZDV) on the long-term survival of AIDS patients.

The influence of treatment with zidovudine (ZDV) and other factors on long-term survival of AIDS patients was analyzed in a cohort of 629 adults. A total of 434 (69%) were diagnosed before ZDV became routinely available in Spain (December 1987) or refused the drug, while the remaining 195 (31%) received ZDV (starting at a dose of 750-1,200 mg/day). A total of 412 (65.

Efficacy of octreotide in the management of chronic diarrhoea in AIDS.

Patients with HIV infection were studied to assess the efficacy of octreotide, a somatostatin analogue, in the long-term management of refractory diarrhoea. Dosage of subcutaneous octreotide was increased progressively at 48 h intervals from 150 to 300, 750 and 1500 micrograms/day according to response. Twenty-nine patients, 21 with Cryptosporidium enteritis, one with Isospora belli enteritis and seven with no identifiable pathogen were selected for the study; four of these were excluded from the study because of death during the first month (two cases), abdominal pain and acute pancreatitis (one case each).

Septic arthritis in heroin addicts.

Over a 6-year period (1982 to 1988), 36 episodes of septic arthritis were diagnosed in 35 heroin addicts from Barcelona, Spain. Thirty (86%) were men and five (14%) were women, with a mean age of 24 years (range, 14 to 39). Twenty-nine episodes (80%) were monoarticular and seven (20%) were oligoarticular.

[Syphilis and human immunodeficiency virus infection: diagnostic and therapeutic problems. Presentation of 2 cases and review of the literature].

We here present the clinical cases of two homosexual patients, carriers of human immunodeficiency virus (HIV), who later presented a syphilis infection and who after receiving the usually recommended treatment, suffered a relapse of the infection six months afterwards, with neurologic involvement in one case. The clinical characteristics are discussed as well as the diagnostic and therapeutic problems which syphilis infection presents in HIV infected patients. Serological results are comparable to those of the general population, although face positives have been occasionally reported as well as some abnormally elevated titers.

Antibiotic prophylaxis in non-cardiac thoracic surgery: cefazolin versus placebo.

A total of 127 patients (57 given placebo and 70 given a single preoperative dose of 1 g cefazolin) undergoing thoracic surgery were included in a randomized double-blind trial. The two groups were similar in regard to mean age, sex ratio, in-hospital stay before surgery, underlying disease, risk factors, type of surgery, mean duration of surgical procedure, and mean duration of chest tube drainage. The relative risk of wound infection of the patients from the placebo group was 3.

Visceral leishmaniasis in patients infected with human immunodeficiency virus. Co-operative Group for the Study of Leishmaniasis in AIDS.

We describe 40 HIV-seropositive patients who developed visceral leishmaniasis. All the patients lived in areas endemic for visceral leishmaniasis and belonged to groups at risk for AIDS. Twenty-three patients (57.

[Encephalic toxoplasmosis in patients with the acquired immunodeficiency syndrome. A clinico-radiological study and the therapeutic results in 78 cases].

During a 40-month period 78 episodes of encephalic toxoplasmosis (ET) were diagnosed in 57 patients among 394 with acquired immunodeficiency syndrome (AIDS) (based on CDC criteria) in the Hospital Clinic from Barcelona. 38 patients were parenteral drug abusers (66.7%), 17 were homosexual males (29.

[Diagnosis of pneumonia caused by Pneumocystis carinii using induced sputum].

Pneumocystis carinii pneumonia is one of the most common and severe infections in patients with human immunodeficiency virus (HIV) infection. Classically, the diagnosis of this condition is made with aggressive techniques such as fibrobronchoscopy (FBS) with bronchoalveolar lavage (BAL) or pulmonary biopsy. Sputum induction is a relatively recent technique which permits the diagnosis in a rapid, inexpensive way which is not aggressive for the patient.