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Berenguer J, Zamora FX, Aldámiz-Echevarría T, Von Wichmann MA, Crespo M, López-Aldeguer J, Carrero A, Montes M, Quereda C, Téllez MJ, Galindo MJ, Sanz J, Santos I, Guardiola JM, Barros C, Ortega E, Pulido F, Rubio R, Mallolas J, Tural C, Jusdado JJ, Pérez G, Díez C, Álvarez-Pellicer J, Esteban H, Bellón JM, González-García J, Miralles P, Cosín J, López J, Padilla B, Parras F, Carrero A, Aldamiz-Echevarría T, Tejerina F, Gutiérrez I, Ramírez M, Carretero S, Bellón J, Berenguer J, Alvarez-Pellicer J, Rodríguez E, Arribas J, Montes M, Bernardino I, Pascual J, Zamora F, Peña J, Arnalich F, Díaz M, González-García J, Bustinduy M, Iribarren J, Rodríguez-Arrondo F, Von-Wichmann M, Blanes M, Cuellar S, Lacruz J, Montero M, Salavert M, López-Aldeguer J, Callau P, Miró J, Gatell J, Mallolas J, Ferrer A, Galindo M, Van den Eynde E, Pérez M, Ribera E, Crespo M, Vergas J, Téllez M, Casado J, Dronda F, Moreno A, Pérez-Elías M, Sanfrutos M, Moreno S, Quereda C, Jou A, Tural C, Arranz A, Casas E, de Miguel J, Schroeder S, Sanz J, Condés E, Barros C, Sanz J, Santos I, Hernando A, Rodríguez V, Rubio R, Pulido F, Domingo P, Guardiola J, Ortiz L, Ortega E, Torres R, Cervero M, Jusdado J, Rodríguez-Zapata M, Pérez G, Gaspar G, Barquilla E, Ramírez M, Moyano B, Aznar E, Esteban H. Comparison of the Prognostic Value of Liver Biopsy and FIB-4 Index in Patients Coinfected With HIV and Hepatitis C Virus. Clin Infect Dis 2014; 60:950-8. [DOI: 10.1093/cid/ciu939] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Affiliation(s)
- Juan Berenguer
- Hospital General Universitario Gregorio Marañón
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM)
| | - Francisco X. Zamora
- Hospital Universitario La Paz
- Instituto de Investigación Sanitaria La Paz (IdiPAZ), Madrid
| | - Teresa Aldámiz-Echevarría
- Hospital General Universitario Gregorio Marañón
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM)
| | | | | | | | - Ana Carrero
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM)
| | - Marisa Montes
- Hospital Universitario La Paz
- Instituto de Investigación Sanitaria La Paz (IdiPAZ), Madrid
| | | | | | | | - José Sanz
- Hospital Universitario Príncipe de Asturias, Alcalá de Henares
| | | | | | | | | | - Federico Pulido
- Hospital Universitario 12 de Octubre
- Instituto de Investigación Hospital 12 de Octubre
(i+12), Madrid
| | - Rafael Rubio
- Hospital Universitario 12 de Octubre
- Instituto de Investigación Hospital 12 de Octubre
(i+12), Madrid
| | | | | | | | | | - Cristina Díez
- Hospital General Universitario Gregorio Marañón
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM)
| | - Julio Álvarez-Pellicer
- Hospital Universitario La Paz
- Instituto de Investigación Sanitaria La Paz (IdiPAZ), Madrid
| | | | - José M. Bellón
- Hospital General Universitario Gregorio Marañón
- Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM)
| | - Juan González-García
- Hospital Universitario La Paz
- Instituto de Investigación Sanitaria La Paz (IdiPAZ), Madrid
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Bernal-Bello D, García de Tena J, Abejón-López L, Megino-Moreno T, Barrio-Gordillo J, Rodríguez-Zapata M. Afectación atípica de palmas y plantas en la neumonía por varicela. Rev Clin Esp 2012; 212:e25-7. [DOI: 10.1016/j.rce.2011.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2011] [Accepted: 10/17/2011] [Indexed: 11/15/2022]
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Martín-Echevarria E, Rodríguez-Zapata M, Torralba M, Fernández J, Moreno A, Casado J, Dronda F, Pérez-Elías M, Navas E, Moreno S. Incidence of tuberculosis in HIV-infected patients receiving HAART: interaction between TST and CD4 count. Int J Tuberc Lung Dis 2011; 15:1347-52. [DOI: 10.5588/ijtld.10.0686] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
| | - M. Rodríguez-Zapata
- Internal Medicine Service, Hospital Universitario de Guadalajara, Guadalajara
| | - M. Torralba
- Internal Medicine Service, Hospital Universitario de Guadalajara, Guadalajara
| | - J.M.R. Fernández
- Infectious Diseases Service, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - A. Moreno
- Infectious Diseases Service, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - J.L. Casado
- Infectious Diseases Service, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - F. Dronda
- Infectious Diseases Service, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - M.J. Pérez-Elías
- Infectious Diseases Service, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - E. Navas
- Infectious Diseases Service, Hospital Universitario Ramón y Cajal, Madrid, Spain
| | - S. Moreno
- Infectious Diseases Service, Hospital Universitario Ramón y Cajal, Madrid, Spain
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García-Martín F, Sánchez Heras M, Sánchez Martínez L, Rodríguez-Zapata M. [Nephrogenic diabetes insipidus secondary to chronic interstitial nephritis associated with mesalazine therapy]. Rev Clin Esp 2002; 202:245-6. [PMID: 12003743 DOI: 10.1016/s0014-2565(02)71042-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Reyes E, Cardona J, Prieto A, Bernstein ED, Rodríguez-Zapata M, Pontes MJ, Alvarez-Mon M. Liposomal amphotericin B and amphotericin B-deoxycholate show different immunoregulatory effects on human peripheral blood mononuclear cells. J Infect Dis 2000; 181:2003-10. [PMID: 10837182 DOI: 10.1086/315517] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/1999] [Revised: 03/06/2000] [Indexed: 11/03/2022] Open
Abstract
Conventional preparations of amphotericin B (AmB) at established therapeutic doses are known to increase nonspecific immune responses. It remains to be established whether higher doses of the less toxic liposomal preparation of AmB maintains a beneficial effect on the immune response to fungal infections. Examination of the effect of treatment of human peripheral blood mononuclear cells from healthy subjects with various doses of both liposomal AmB (L-AmB) and deoxycholate AmB (d-AmB) on proliferation, cell viability, and percentage of apoptosis demonstrated that, although both L-AmB and d-AmB at low doses significantly increased nonspecific proliferative responses, L-AmB, but not d-AmB, treatment maintained this beneficial effect at higher doses. High doses of d-AmB, but not L-AmB, resulted in significantly decreased cell viability and increased apoptosis. This study provides further evidence in healthy human subjects for choosing L-AmB over conventional preparations in the clinical treatment of fungal infections requiring systemic high-dose treatment with AmB.
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Affiliation(s)
- E Reyes
- Laboratory of Immune System Diseases and Oncology, Department of Medicine, Universidad de Alcalá, Carretera Madrid-Barcelona, 28871 Alcalá de Henares (Madrid), Spain
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Moreno S, Ariza J, Espinosa FJ, Podzamczer D, Miró JM, Rivero A, Rodríguez-Zapata M, Arrizabalaga J, Mateos R, Herrero F. Brucellosis in patients infected with the human immunodeficiency virus. Eur J Clin Microbiol Infect Dis 1998; 17:319-26. [PMID: 9721960 DOI: 10.1007/bf01709454] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Brucellosis has been described rarely in patients infected with HIV, despite the fact that eradication of intracellular brucellae is largely dependent on cell-mediated immunity. The characteristics of all patients with HIV infection and brucellosis seen in seven Spanish hospitals are reported. Since the beginning of the AIDS epidemic, 12 HIV-infected patients were diagnosed with brucellosis (8 with cultures positive for Brucella spp., 4 with high anti-Brucella antibody titers). Most patients were male and intravenous drug users. Eleven patients had no symptoms of HIV infection when first diagnosed with brucellosis and had relatively preserved cellular immunity (median CD4 + cell count 588, range 136-1006). There was a clear epidemiologic antecedent for acquisition of brucellosis in 11 patients. Clinical symptoms included fever, arthromyalgia, and sweating in all patients; four patients presented with focal disease. All patients had high agglutinin titers, and eight of nine had cultures positive for Brucella. Therapy with doxycycline and streptomycin was curative in all cases. Two patients experienced a recurrence of symptoms after initial treatment, although no microbiological relapses were documented after a median follow-up period of 18 months. HIV infection does not seem to increase the incidence of brucellosis. Since most cases occur in asymptomatic patients with relatively preserved immunity, the epidemiology, clinical presentation, diagnosis, response to therapy, and outcome are similar to those observed in non-HIV infected patients.
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Affiliation(s)
- S Moreno
- Department of Clinical Microbiology, Hospital General Universitario J.Ma Morales Meseguer, Murcia, Spain
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Abstract
Demographic, clinical, and laboratory data from 200 consecutive patients with acute brucellosis were analysed with univariate and multivariate methods to identify correlates of relapse. A risk score for predicting relapse was then calculated by using Cox proportional hazard model. The independent predictors of relapse were temperature of 38.3 degrees C or higher, positive blood cultures at baseline, and the duration of symptoms before treatment <10 days. Stratification according to the risk score demonstrated that rates of relapse were significantly different between risk groups (P<0.0001). The low-risk group had a 4.5% probability (6 of 135) of relapse at 12 months. In contrast, relapse was present in 15 of 47 patients in the medium-risk group (P<0.0017); and in 12 of 18 patients in the high-risk group (P<0.0001). This study provides a rational basis for estimating the risk of relapse in patients with acute brucellosis, and may be helpful in deciding what subjects might benefit from extra attention.
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Affiliation(s)
- J Solera
- Department of Medicine, Unit of Infectious Diseases, Hospital of Albacete, Spain
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Solera J, Rodríguez-Zapata M, Geijo P, Largo J, Paulino J, Sáez L, Martínez-Alfaro E, Sánchez L, Sepulveda MA, Ruiz-Ribó MD. Doxycycline-rifampin versus doxycycline-streptomycin in treatment of human brucellosis due to Brucella melitensis. The GECMEI Group. Grupo de Estudio de Castilla-la Mancha de Enfermedades Infecciosas. Antimicrob Agents Chemother 1995; 39:2061-7. [PMID: 8540716 PMCID: PMC162881 DOI: 10.1128/aac.39.9.2061] [Citation(s) in RCA: 103] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Brucellosis is a common zoonosis in many parts of the world; the best regimen for the treatment of brucellosis has not been clearly determined. We have carried out a multicenter, open, controlled trial in five general hospitals in Spain to compare the efficacy and safety of doxycycline and rifampin (DR) versus doxycycline and streptomycin (DS) for the treatment of human brucellosis. The study included 194 ambulatory or hospitalized patients with acute brucellosis, without endocarditis or neurobrucellosis. The diagnostic criterion was isolation of Brucella species from blood or other tissues (n = 120) or a standard tube agglutination titer of 1/160 or more for anti-Brucella antibodies with compatible clinical findings (n = 74). Patients were randomly assigned to receive either 100 mg of doxycycline twice daily plus rifampin, 900 mg/day, in a single morning dose for 45 days (DR group) or the same dose of doxycycline for 45 days plus streptomycin, 1 g/day, intramuscularly for 14 days (DS group). A lack of therapeutic efficacy developed in 8 of the 100 patients in the DR group (8%) and in 2 of the 94 patients in the DS group (2%)(P = 0.10). Relapses occurred in 16 of the 100 patients in the DR group (16%) but in only 5 of the 94 patients in the DS group (5.3%) (P = 0.02). When relapse was considered in combination with initial lack of efficacy, 26 patients in the DR group (24%) and 7 patients in the DS group (7.45%) failed to respond to therapy (P = 0.0016). In general, therapy was well tolerated and only four patients (4%) in the DR group and two (2%) in the DS group had episodes of adverse effects necessitating discontinuation of treatment (P> 0.2). We conclude that a doxycycline-and-rifampin regimen is less effective than the doxycycline-and-streptomycin regimen in patients with acute brucellosis.
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Affiliation(s)
- J Solera
- Department of Medicine, Hospital of Albacete, Spain
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Alvarez-Mon M, Salmerón OJ, Manzano L, Rodríguez-Zapata M, Reyes E, Vaquer LM, Carballido J. Alpha interferon as an immunomodulator in the treatment of patients with tumors. Med Oncol 1995; 12:15-21. [PMID: 8542242 DOI: 10.1007/bf01571404] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- M Alvarez-Mon
- Department of Medicine, Hospital Universitario Principe de Asturias, Hospital Universitario General de Guadalajara, Universidad de Alcala de Henares, Spain
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Salmerón I, Rodríguez-Zapata M, Salmerón O, Manzano L, Vaquer S, Alvarez-Mon M. Impaired activity of natural killer cells in patients with acute brucellosis. Clin Infect Dis 1992; 15:764-70. [PMID: 1445973 DOI: 10.1093/clind/15.5.764] [Citation(s) in RCA: 28] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Researchers have claimed that natural killer (NK) cells are involved in the mechanisms of defense of the host against infections. We have investigated the activity of NK cells in peripheral blood mononuclear cells (PBMNC) from 12 patients for whom acute brucellar infection has been diagnosed and from 14 healthy controls. The sera of eight of the patients were also analyzed 3 months after initiation of a 45-day course of antibiotic treatment, at which time they had no evidence of relapse. PBMNC from patients with acute brucellar infection showed a significantly depressed NK cell activity (P < .01) when compared with those from healthy controls; this depressed activity was not related to a deficient number of NK cells since the numbers of CD56+ and CD16+ cells present in PBMNC were similar in patients and controls. Incubation of PBMNC from patients with acute brucellar infection with recombinant interleukin-2, but not with interferon-gamma, can correct this impaired cytotoxic activity. In treated patients, there was a significant enhancement (P < .05) and normalization of the previously defective NK cell activity. It is concluded that acute brucellar infection is associated with a deficient cytotoxic activity of NK cells that can be overcome by in vitro incubation with interleukin-2 and that reverts to normal after antibiotic treatment.
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Affiliation(s)
- I Salmerón
- Servicio de Medicina Interna, Hospital General Universitario de Guadalajara
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Solera J, Paulino J, Rodríguez-Zapata M, Medrano F, Geijo P, Jiménez F, de Juan L. [Brucellar sacroiliitis. A detailed review with an analysis of treatment efficacy]. Rev Clin Esp 1992; 191:13-8. [PMID: 1631354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
All patients diagnosed of brucellosis in 4 regional hospitals during a period of nine years were reviewed, in an attempt to evaluate the efficacy of different antimicrobic regimens and also the clinical features. Evolution and complications of brucellar sacroiliitis. Of a total of 548 patients, 12% had been diagnosed of sacroiliitis and, of theme, 49 had complete data available with efficacy of different treatments, the time elapsed until fever and pain ceased was evaluated, together with initial therapeutic failures, relapses and length of hospital stay. Brucellar sacroiliitis is the most frequent osteoarthral complication of Brucella sp. in our setting. Keeping an stable incidence. It is predominant among young male (82%) population (mean age 25 +/- 12 years). The illness evolution is acute and less frequently subacute with a evolution mean-time before referral of 38 +/- 44 days (minimum 4 days, maximum 180 days). Fever (81%) and pain on gluteus and low lumbar localizations (100%) are the more frequent clinical features. Time elapsed until pain ceased was longer with doxycycline plus rifampicin (68 +/- 86) than with doxycycline plus streptomycin (28 +/- 43) (less than 0.05) and length of hospital stay was also longer with said treatment (p less than 0.05). There were no differences concerning time frame until fever ceased, initial therapy failures and relapses. Sequelae are infrequent and consist in persistency of pain. In resume response to treatment with usual regimens, doxycycline plus streptomycin of doxycycline rifampicin is good, being however time elapsed until pain ceases of mean length in hospital stay shorter in the group receiving doxycycline plus streptomycin. Control studies to confirm these data are need.
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Affiliation(s)
- J Solera
- Servicio de Medicina Interna, Hospitales Generales de Albacete, Guadalajara y Cuenca
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