16 research outputs found
InfecçÔes fĂșngicas disseminadas com acometimento das supra-renais: descrição de dois pacientes brasileiros HIV-negativos
A paracoccidioidomicose e a histoplasmose sĂŁo infecçÔes fĂșngicas sistĂȘmicas endĂȘmicas no Brasil. As formas clĂnicas disseminadas sĂŁo incomuns em pacientes imunocompetentes. NĂłs descrevemos dois pacientes HIV-negativos com infecçÔes fĂșngicas disseminadas, paracoccidioidomicose e histoplasmose, que foram diagnosticadas por biĂłpsias de lesĂ”es de supra-renal. Ambos foram tratados por perĂodos prolongados com antifĂșngicos orais, evoluindo com boa resposta terapĂȘutica.Paracoccidioidomycosis and histoplasmosis are systemic fungal infections endemic in Brazil. Disseminated clinical forms are uncommon in immunocompetent individuals. We describe two HIV-negative patients with disseminated fungal infections, paracoccidioidomycosis and histoplasmosis, who were diagnosed by biopsies of suprarenal lesions. Both were treated for a prolonged period with oral antifungal agents, and both showed favorable outcomes
Chronic hepatitis C: hepatic iron content does not correlate with response to antiviral therapy
The complex interaction between hepatitis C virus infection, iron homeostasis and the response to antiviral treatment remains controversial. The aim of this study was to evaluate the influence of hepatic iron concentration (HIC) on the sustained virological response (SVR) to antiviral therapy in patients with chronic hepatitis C. A total of 50 patients who underwent pretreatment liver biopsy with assessment of HIC by graphite furnace atomic absorption spectroscopy and were subsequently submitted to antiviral treatment with interferon/peginterferon and ribavirin were included in the study. Patients with alcoholism, history of multiple blood transfusion, chronic kidney disease, hemolytic anemia and parenteral iron therapy were excluded. The iron related markers and HIC were compared between those who achieved an SVR and non-responders (NR) patients. The mean age was 45.7 years and the proportion of patients' gender was not different between SVR and NR patients. The median serum iron was 138 and 134 ”g/dL (p = 0.9), the median serum ferritin was 152.5 and 179.5 ng/mL (p = 0.87) and the median HIC was 9.9 and 8.2 ”mol/g dry tissue (p = 0.51), for SVR and NR patients, respectively. Thus, hepatic iron concentration, determined by a reliable quantitative method, was not a negative predictive factor of SVR in patients with chronic hepatitis C presenting mild to moderate hepatic iron accumulation.A complexa interação entre infecção pelo vĂrus da hepatite C, homeostase do ferro e resposta ao tratamento antiviral permanece controversa. O objetivo deste estudo foi avaliar a influĂȘncia da concentração hepĂĄtica de ferro (CHF) na resposta virolĂłgica sustentada (RVS) Ă terapia antiviral na hepatite C crĂŽnica. Foram incluĂdos 50 pacientes que foram submetidos Ă biopsia hepĂĄtica prĂ©-tratamento com determinação da CHF por espectrofotometria de absorção atĂŽmica com forno de grafite e tratados posteriormente com interferon/peginterferon e ribavirina. Pacientes com alcoolismo, histĂłria de mĂșltiplas transfusĂ”es sanguĂneas, doença renal crĂŽnica, anemia hemolĂtica e terapia com ferro parenteral foram excluĂdos. O perfil de ferro sĂ©rico e a CHF foram comparados entre aqueles que atingiram RVS e os nĂŁo-respondedores (NR). A mĂ©dia de idade dos pacientes foi 45,7 anos e nĂŁo houve diferença na proporção de homens e mulheres entre os grupos RVS e NR. A mediana do ferro sĂ©rico foi 138 and 134 ”g/dL (p = 0.9), a mediana da ferritina sĂ©rica foi 152,5 e 179,5 ng/mL (p = 0,87) e a CHF mediana foi 9,9 e 8,2 ”mol/g de tecido seco (p = 0,51), para pacientes com RVS e NR, respectivamente. Concluindo, a concentração hepĂĄtica de ferro, determinada por um mĂ©todo quantitativo confiĂĄvel, nĂŁo foi um fator preditivo negativo de RVS em pacientes com hepatite C crĂŽnica e acĂșmulo de ferro hepĂĄtico leve a moderado
DISSEMINATED FUNGAL INFECTION WITH ADRENAL INVOLVEMENT: REPORT OF TWO HIV NEGATIVE BRAZILIAN PATIENTS
Paracoccidioidomycosis and histoplasmosis are systemic fungal infections endemic in Brazil. Disseminated clinical forms are uncommon in immunocompetent individuals. We describe two HIV-negative patients with disseminated fungal infections, paracoccidioidomycosis and histoplasmosis, who were diagnosed by biopsies of suprarenal lesions. Both were treated for a prolonged period with oral antifungal agents, and both showed favorable outcomes
Estudo comparativo das lesÔes hepåticas em biopsias de pacientes portadores crÎnicos do HBsAg e/ou soropositivos para o anti-HCV, oriundos de unidades de diålise e banco de sangue.
BV UNIFESP: Teses e dissertaçÔe