From 1987 to 1995, a retrospective case study was conducted at the Ramon y Cajal Hospital in Madrid, Spain, a public teaching hospital with 1,100 beds, to determine the clinicoepidemiologic characteristics, survival, and prognostic factors of patients with visceral leishmaniasis (VL) and human immunodeficiency virus (HIV) infection. The prevalence of VL in HIVϩ patients compared with HIVϪ patients was studied. Epidemiologic, clinical, and parasitologic characteristics, as well as the effects of treatment, prognosis, and survival in 54 HIVϩ patients (90 episodes) with VL were defined. Comparative survival studies among patients with and without acquired immunodeficiency syndrome (AIDS)-defining criteria and multivariate analysis of survival risk factors were performed. The prevalence of VL in patients with AIDS was much higher than in immunocompetent individuals. In spite of a good initial response to treatment for VL, 60.6% of the patients had relapsed by the end of one year. Mortality from the first episode was 18.5%, and 24% died in the first month after diagnosis of any VL episode. The mean survival of the 29 patients who died was 10.27 months. Survival in patients with and without AIDS at the time of the first episode of VL was compared at 30 months: 53.7% versus 20.5% (P ϭ 0.00149). We found no significant difference (P ϭ 0.24) in the survival of HIVϩ patients who had died of VL without AIDS at the time of the first episode of VL compared with those of a control group of 413 dead patients with AIDS without VL. A diagnosis of AIDS at the time of the first episode of VL and thrombocytopenia were the only risk factors found related to survival. We conclude that in AIDS patients, VL is a recurrent disease that is highly prevalent and whose clinical course is modified by HIV.
Objective. To assess different aspects of the perception of sexuality among students before and after a workshop. Population and methods. Descriptive, qualitative, and quantitative before and after intervention study without a control group. School year, status in relation to sexuality, preferred sources of information, and perception of self-care in relation to sexuality care were analyzed. Results. A total of 272 surveys were completed before the workshop and 259, after the workshop. The perception about a better level of information increased (72.3 % versus 90.7 %), and doubts, fears, and embarrassment decreased. The preference for the workshop as an information source increased (49.1 % versus 69.9 %), and an improvement was observed in the perception of a correct use of condoms (66.8 % versus 81.1 %), birth control pills (20.3 % versus 42.5 %), and emergency contraception (18.5 % versus 40.9 %). Conclusion. Students' information and perception of self-care in relation to sexuality increased.
Biliary excretion of ceftazidime, a new broad-spectrum cephalosporin, was studied in two groups of patients after administration of a 2-g dose intravenously. Group A included 10 patients in whom ceftazidime levels in bile were measured during cholecystectomy. Group B included 10 patients with indwelling biliary tubes in whom ceftazidime levels in bile and serum were simultaneously measured at 0.5, 1, 2, 4, 6, and 8 h after administration of the drug. Although ceftazidime levels were variable, they exceeded the minimal inhibitory concentrations of most biliary tract pathogens in both groups.
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