The HIV group presented in baseline conditions, a shift of cardiac sympathovagal balance, an exacerbated response of the LF component during the tilt test, and an ineffective cardiac vagal response to the cold-face test suggesting sympathetic and parasympathetic dysfunction. AIDS patients receiving HAART did not present these autonomic alterations.
As a group, indeterminate Chagas' disease subjects showed unaltered short-term heart interval variability. Individual somewhat widespread of majority of time- and frequency-domain indices, from depressed to exacerbated ones appears to exist. This conforms to a variable cardiac autonomic modulation in this form of disease, suggesting that the majority of chagasics has no lesions, and a minority has subtle lesions of the efferent innervation-sinus node complex.
A prospective study of 62 patients with systemic lupus erythematosus (SLE) was performed in order to establish whether serum beta 2m could be a good marker of clinical activity. beta 2m was determined by radio-immunoassay and the values compared with a control group of healthy individuals. The mean value of beta 2m in the control group was 1.48 +/- 0.52 mg/l and 2.87 +/- 2.19 mg/l (p less than 0.001) in the SLE group, 4.53 +/- 2.89 mg/l in the 22 patients with active disease and 2.40 +/- 1.80 mg/l (p less than 0.001) in the 40 patients with inactive disease. High beta 2m values (greater than or equal to 3 mg/l) were observed in 64% of the patients with active SLE, VS. only 12% of the patients with inactive disease (p less than 0.001). Significant differences were also observed when beta 2m of the patients with inactive SLE was compared with the control group (p less than 0.001). The beta 2m with a sensitivity of 64%, a specificity of 87%, and an efficiency of 79% could be a good parameter to detect SLE clinical activity.
SUMMARYThis report describes two patients who presented acute disseminated and severe toxoplasmosis as the first opportunistic disease related to acquired immunodeficiency syndrome. At admission, clinical and laboratory findings were similar to sepsis or septic shock and a fast evolutive course to death occurred in both cases. At necropsy, an inflammatory reaction and presence of a great number of Toxoplasma gondii cysts and tachyzoites were observed in most organs examined.
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