Urinary tract infection (UTI) is a common condition around the world, even affecting immunocompromised hosts such as people with human immunodeficiency virus (HIV) infection or acquired immuodeficiency syndrome (AIDS). Due to the anatomical conditions of the urogenital tract, women are more susceptible to UTI. Risk factors throughout life are determinants in the appearance of UTI. The frequency increases especially in women and is associated with sexual activity and pregnancy. In older adults and the elderly, again the frequency of UTI in both genders increases. In women, it is usually related at anatomical and functional sequelae due to parity and gyneco-obstetric surgeries. In old men, prostatic enlargement is an important concern. Chronic degenerative diseases such as diabetes mellitus with complications explain the high frequency of UTI in this population. Currently, the increase in violence and accidents are the leading cause of traumatic injuries with neurological damage, which leads the use of permanent urinary catheter. In patients infected with HIV/AIDS, the disease can be severe and is associated with more complications. The etiology in this population can be diverse, including fungi, parasites, and virus; antimicrobial resistance is a therapeutic challenge. This chapter is a comprehensive review of the epidemiology, pathophysiology, clinical presentation, diagnosis approach, and current treatment of UTIs in HIV/AIDS patients.
Background and Aims Inflammatory bowel disease (IBD) is a prevalent chronic noncurable disease associated with profound metabolic changes. The discovery of novel molecular indicators for unraveling IBD etiopathogenesis and the diagnosis and prognosis of IBD is therefore pivotal. We sought to determine the distinctive metabolic signatures from the different IBD subgroups before treatment initiation. Methods Serum and urine samples from newly diagnosed treatment-naïve IBD patients and age and sex-matched healthy control (HC) individuals were investigated using proton nuclear magnetic resonance spectroscopy. Metabolic differences were identified based on univariate and multivariate statistical analyses. Results A total of 137 Crohn’s disease patients, 202 ulcerative colitis patients, and 338 HC individuals were included. In the IBD cohort, several distinguishable metabolites were detected within each subgroup comparison. Most of the differences revealed alterations in energy and amino acid metabolism in IBD patients, with an increased demand of the body for energy mainly through the ketone bodies. As compared with HC individuals, differences in metabolites were more marked and numerous in Crohn’s disease than in ulcerative colitis patients, and in serum than in urine. In addition, clustering analysis revealed 3 distinct patient profiles with notable differences among them based on the analysis of their clinical, anthropometric, and metabolomic variables. However, relevant phenotypical differences were not found among these 3 clusters. Conclusions This study highlights the molecular alterations present within the different subgroups of newly diagnosed treatment-naïve IBD patients. The metabolomic profile of these patients may provide further understanding of pathogenic mechanisms of IBD subgroups. Serum metabotype seemed to be especially sensitive to the onset of IBD.
<span style="font-size: 10pt; color: #231f20; font-family: Garamond-Bold; mso-fareast-font-family: 'Times New Roman'; mso-bidi-font-family: Garamond-Bold; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;"><strong><span style="font-family: Times New Roman;">O</span></strong></span><span style="font-size: 10pt; color: #231f20; font-family: Arial; mso-fareast-font-family: 'Times New Roman'; mso-ansi-language: ES; mso-fareast-language: ES; mso-bidi-language: AR-SA;"><strong>bjetivo:</strong> comparar el efecto de una intervención educativa multidisciplinaria versus manejo convencional en la calidad de vida, índice de masa corporal y presión arterial de pacientes hipertensos. Diseño: experimental de intervención educativa. <strong>Métodos:</strong> de marzo a octubre de 2005 se realizó una intervención educativa multidisciplinaria en una unidad de primer nivel de atención; participaron especialistas en Medicina Familiar, nutriólogos, trabajadoras sociales y un especialista en Salud Mental. El grupo experimental recibió la intervención que consistió en cinco sesiones durante tres meses; se evaluó la calidad de vida, índice de masa corporal y presión arterial, se utilizó la prueba de t para determinar las diferencias entre los grupos, p ≤ 0.05 fue significativa. <strong>Resultados:</strong> se asignaron aleatoriamente 25 pacientes al grupo experimental y 25 al grupo control. En la evaluación inter-grupal el grupo experimental presentó mejoría global de 10 puntos en la calidad de vida (p=0.001), la disminución promedio en la presión arterial fue de 10 mmHg en la media, (p=0.001), el índice de masa corporal sólo disminuyó en el grupo experimental en 1 kg/mt2 (p=0.001). <strong>Conclusión:</strong> la participación multidisciplinaria tiene un mayor impacto en la calidad de vida y el control de la presión arterial.</span>
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